河南农村人群维生素D水平与高血压患病风险的关联

Association of vitamin D and risk of hypertension in Henan rural population

目的调查河南农村居民的维生素D(vitamin D,VD)缺乏以及高血压流行现状,探讨VD水平与高血压患病风险之间的关联。方法整群抽样方法选取18~80岁河南农村居民为研究对象,采用Logistic回归计算VD与高血压患病风险之间的OR值和95%CI,并使用限制性立方样条模型拟合VD与高血压患病风险之间的剂量-反应关系。结果共纳入研究对象2 013人,血清25-羟基维生素D(25-hydroxy-vitamin D,25-(OH) D)平均水平为(24. 50±16. 18) ng/ml,其中VD缺乏者占53. 95%,不足者占27. 02%,只有19. 03%能达到正常水平;高血压患病率为40. 34%(年龄标化率30. 64%)。高血压患者VD水平低于非高血压人群,且VD缺乏人群的高血压患病率(45. 21%)高于VD充足人群(31. 07%);相比VD充足人群,VD缺乏人群的高血压患病风险升高(OR=1. 59,95%CI:1. 21~2. 10),血清VD水平每升高10 ng/ml,高血压患病风险下降14%,限制性立方样条模型显示VD水平与高血压患病风险存在"L"型剂量-反应关系。结论 VD缺乏与高血压患病风险升高有关,VD水平与高血压患病风险存在"L"型剂量-反应关系。

Objective The purpose of this study was to investigate the prevalence of vitamin D deficiency and hypertension in Henan rural residents,and to explore the association between vitamin D and risk of hypertension. Methods 2 013 Henan rural participants aged 18-80 years were recruited from a cross-sectional study. Logistic regression models and restricted cubic spline model were used to evaluate odds ratios( OR),95% confidence intervals( 95% CI) and dose-response relationship between vitamin D and risk of hypertension. Results In total population,the prevalence of hypertension was40. 34%( 30. 64% after age-standard),and the mean serum 25-( OH) D was( 24. 50 ± 16. 18) ng/ml,and 53. 95% of all participants were presenting vitamin D deficiency. Compared with non-hypertension,a lower level of serum 25-( OH) D was observed in people with hypertension. The prevalence of hypertension was 45. 21% in vitamin D deficient group which was higher than in the vitamin D sufficient group( 31. 07%). Compared with the vitamin D sufficient group,the risk of hypertension was increase in the vitamin D deficient group( OR = 1. 59,95% CI: 1. 21-2. 10),and the risk of hypertension decreased by 14% for every 10 ng/ml increase in serum 25-( OH) D levels. Moreover,an L-shaped relationship was observed between 25-( OH) D concentration and risk of hypertension. Conclusion Vitamin D deficiency is associated with risk of hypertension and there is an L-shaped relationship between 25-( OH) D concentration and risk of hypertension.