勺型及非勺型高血压患者血清25羟维生素D3水平与外周血管硬化的相关性分析

Correlation Between Serum 25 Hydroxyvitamin D3 Level and Peripheral Vascular Sclerosis in Hypertensive Patients of Dipper and Non-dipper Type

目的探讨血清25羟维生素D3水平与非勺型高血压患者外周血管硬化指数心踝血管指数(cardioankle vascular index,CAVI)的相关性。方法选取2017年1-6月于川北医学院附属医院心内科及老年科门诊及住院原发性高血压患者155例,根据动态血压监测结果分为勺型高血压组和非勺型高血压,记录年龄、体质量指数及高血压病程,并检测血脂、血糖、糖化血红蛋白水平,采用酶联免疫法测定血清25羟维生素D3水平,动脉硬化指数采用CAVI进行评估,比较两组各项指标的差异。结果勺型高血压60例(38.7%),非勺型高血压95例(61.3%)。两组年龄、体质量指数、高血压病程、甘油三酯、胆固醇、低密度脂蛋白、高密度脂蛋白、空腹血糖及糖化血红蛋白比较,差异无统计学意义(P>0.05),非勺型高血压患者血清25羟维生素D3水平明显低于勺型高血压组(P<0.01),CAVI明显高于勺型高血压组(P<0.01),多元线性回归分析提示年龄,25羟维生素D3是CAVI的独立影响因素,25羟维生素D3每降低1nmol可使CAVI增加0.06。结论与勺型高血患者相比,非勺型高血压患者血清25羟维生素D3降低,外周血管硬化指数增加,血清25羟维生素D3水平降低是非勺型高血压患者外周血管硬化指数增加的危险因素。

Objectives To investigate the correlation between the serum 25 Hydroxyvitamin D3 level and the cardio ankle vascular index （CAVI） of peripheral vascular sclerosis index in hypertensive patients of dipper and non dipper type. Methods A total of 155 outpatients and inpatients with essential hypertension treated in Affiliated Hospital of North Sichuan Medical Collage from January to June of 2017 were enrolled and divided into the dipper group and the non dipper group according to the results of 24 hour ambulatory blood pressure monitoring. Their age, body mass index （BMI） and course of hypertension were recorded and the levels of plasma lipids, blood glucose, glycosylated hemoglobin were detected. The ELISA assay was used to detect the level of serum 25 Hydroxyvitamin D3 and CAVI was used to assess the atherogenic index. Then the differences of those indexes were compared between the groups. Results The dipper hypertension was diagnosed in 60 patients accounting for 38.7%, while the non dipper hypertension was diagnosed in 95 patients accounting for 61.3%. There were no significant differences between the two groups in age, BMI, course of hypertension, triglycerides, cholesterol, low density and high density lipoprotein, fasting blood glucose and glycosylated hemoglobin （P 〉 0.05）. The hypertensive patients of non dipper type had significantly lower levels in serum 25 Hydroxyvitamin D3 （P〈0.01） and significantly higher levels in CAVI （P〈0.01） when compared with those of dipper type. The multivariate regression analysis demonstrated that the age and level of serum 25 Hydroxyvitamin D3 were the independent influencing factors of CAVI, and the increase of 25 hydroxyvitamin D3 by lnmol resulted in the increase of CAVI by 0.06. Conclusion The hypertensive patients of non dipper type has lower levels of serum 25 Hydroxyvitamin D3 and higher levels of peripheral vascular sclerosis index than those of dipper type, and the decreased level of serum 25 Hydroxyvitamin D3 is the risk factor of increasing the peripheral vascular sclerosis level in the hypertensive patients of non-clipper type.