维生素D缺乏与慢性肾脏病患者血管内皮细胞功能异常的相关性研究

Association of vitamin D deficiency and endothelial dysfunction in patients with chronic kidney disease

目的观察慢性肾脏病(CKD)患者血清25-羟维生素D水平与血管内皮细胞功能异常的相关性。方法选取病情稳定的非透析CKD患者为研究对象,以血流介导的血管舒张功能(FMD)作为评价血管内皮细胞功能的指标,观察血清25-羟维生素D水平与FMD的相关性。结果符合条件的139例患者进入本研究,血清25-羟维生素D缺乏、不足及正常的患者分别为71例(51.08%)、58例(41.73%)和10例(7.19%)。25-羟维生素D缺乏与不足患者的肱动脉FMD低于25-羟维生素D水平正常者,并以缺乏组患者的FMD最低。相关分析显示,血清25-羟维生素D与肱动脉FMD呈显著正相关(r=0.623,P<0.01),多因素回归分析显示血清25-羟维生素D水平降低是血管内皮细胞损伤的独立危险因素(β=0.418,P<0.01)。结论血清25-羟维生素D水平降低是非透析CKD患者血管内皮细胞功能异常的独立危险因素,补充25-羟维生素D可能有助于改善患者的内皮细胞功能。

Objective To investigate the correlation between vitamin D deficiency and endothelial dysfunction in patients with non-dialysis chronic kidney disease(CKD）. Methods Patients with non-dialysis CKD and a stable clinical state were enrolled in this study. Vitamin D status of the patients was determined using serum 25-hydroxyvitamin D. Endothelial function was assessed by brachial artery flow-mediated dilation(FMD）. Results Of 139 patients enrolled,there were 71(51. 08%） cases of vitamin D deficiency,58(41. 73%） cases of vitamin D insufficiency and only 10 had normal vitamin D level. Patients with vitamin D deficiency and insufficiency had lower brachial artery FMD than patients with sufficient vitamin D level with the lowest level observed in vitamin D deficient group. Correlation analysis showed a positive correlation between FMD and 25(OH） D(r = 0. 623,P〈 0. 01）. The multiple regression analysis revealed vitamin D deficiency was an independent risk factor for endothelial dysfunction(β = 0. 418,P 〈0. 01）. Conclusions Vitamin D deficiency was associated with endothelial dysfunction in patients with non-dialysis CKD. Vitamin D supplementation may improve endothelial function in these patients.