25-羟维生素D与高血压肾损害的相关性研究分析

Analysis of the Relationship Between 25-hydroxyvitamin D and Renal Damage in Hypertension

目的通过观察原发性高血压及高血压肾损害患者血清25-羟维生素D浓度变化及与其他指标的相关性,探讨其在高血压及高血压肾损害中的作用及临床意义。方法收集原发性高血压病人80例,根据24 h尿蛋白定量结果分为单纯高血压组42例和高血压肾损害组38例,另将体检中心提供的40例健康人群设为对照组,收集所有受试者的性别、年龄、身高、体重、入院血压、空腹血糖、血脂、肾功能等指标,分析血清25-羟维生素D水平与各临床指标及高血压、高血压肾损害的相关性。结果(1)3组性别、年龄、身高、体重差异无统计学意义(P>0.05);(2)对照组的血压均低于单纯高血压组及高血压肾损害组,差异有统计学意义(P<0.05);(3)3组空腹血糖、高密度脂蛋白胆固醇、三酰甘油差异无统计学意义(P>0.05);(4)对照组胆固醇、低密度脂蛋白胆固醇、hsCRP、胱抑素C均低于单纯高血压组及高血压早期肾损害组,差异具有统计学意义(P<0.05);(5)单纯高血压组胆固醇、低密度脂蛋白胆固醇、hsCRP、胱抑素C低于高血压早期肾损害组,差异具有统计学意义(P<0.05);(6)单纯高血压组Scr高于对照组(P<0.05),但仍在正常范围;BUN差异无统计学意义(P>0.05)。高血压肾损害组BUN及Scr均高于单纯高血压组及对照组(P<0.05);(7)对照组25-羟维生素D水平高于单纯高血压组及高血压肾损害组,差异具有统计学意义(P<0.05);单纯高血压组25-羟维生素D水平高于高血压早期肾损害组,差异具有统计学意义(P<0.05);(8)单纯高血压组与高血压早期肾损害组24 h尿微量蛋白差异具有统计学意义(P<0.05);25-羟维生素D水平与其他各项观察指标进行双变量直线相关性分析。结论Pearson相关分析结果表明:全部高血压患者25-羟维生素D与收缩压、舒张压、总胆固醇、低密度脂蛋白、胱抑素C及hsCRP呈负相关,差异有统计学意义(P<0.05)。高血压早期肾损害组25-羟维生素D水平与24 h尿微量白蛋白呈负相关,差异具有统计学意义(P<0.05)。

Objective To observe the changes of serum 25 hydroxyvitamin D concentration and its correlation with other indicators in patients with essential hypertension and hypertensive renal damage,and to explore its role and clinical significance in hypertension and hypertensive renal damage.Methods 80 patients with essential hypertension were divided into simple hypertension group(n=42)and hypertensive renal damage group(n=38)according to 24-hour urine protein quantitative results.Another 40 healthy people provided by the physical examination center were set as the control group.The gender,age,height,weight,admission blood pressure,fasting blood glucose,blood lipid,renal function and other indicators of all subjects were collected,and serum 25 The correlation between the level of-hydroxyvitamin D and clinical indexes,hypertension and hypertensive renal damage.Results(1)there was no significant difference in gender,age,height and weight among the three groups(P>0.05);(2)the blood pressure of the control group was lower than that of the simple hypertension and hypertensive renal damage group(P<0.05);(3)there was no significant difference in fasting blood glucose(TBG),high-density lipoprotein cholesterol(HDL-C)and triglyceride(TG)among the three groups(P>0.05);(4)there was no significant difference in the control group The levels of cholesterol(TC),low density lipoprotein cholesterol(LDL-C),hsCRP and cystatin C were significantly lower than those of simple hypertension and early renal damage group(P<0.05);(5)the levels of cholesterol(TC),low density lipoprotein cholesterol(LDL-C),hsCRP and cystatin C of simple hypertension group were significantly lower than those of early renal damage group(P<0.05);(6)the levels of cholesterol(TC),low density lipoprotein cholesterol(LDL-C),hsCRP and cystatin C of simple hypertension group were significantly lower than those of early renal damage group(P<0.05)SCR in the pure hypertension group was higher than that in the control group(P<0.05),but still in the normal range;bun had no significant difference(P>0.05).Bun and SCR in hypertensive renal damage group were higher than those in simple hypertension group and control group(P<0.05);(7)the level of 25 hydroxyvitamin D in control group was higher than that in simple hypertension group and hypertensive renal damage group,The difference was statistically significant(P<0.05);the level of 25 hydroxyvitamin D in simple hypertension group was higher than that in early renal damage group(P<0.05);the difference was statistically significant(P<0.05);(8)the difference of 24-hour urinary microprotein between simple hypertension group and early renal damage group was statistically significant(P<0.05);the level of 25 hydroxyvitamin D was analyzed with bivariate linear correlation analysis with other observation indexes.Conclusion Pearson correlation analysis showed that 25 hydroxyvitamin D was negatively correlated with systolic blood pressure,diastolic blood pressure,total cholesterol(TC),low density lipoprotein(LDL-C),Cystatin C and hsCRP(P<0.05).The level of 25 hydroxyvitamin D was negatively correlated with 24-hour urinary microalbumin(MABL)in the early renal damage group of hypertension,and the difference was statistically significant(P<0.05).