维生素D对冠心病的发生及病变程度的影响

Effect of vitamin D level on the occurrence and severity of coronary atherosclerotic heart disease

目的:探讨维生素D与冠心病发生及其病变程度的相关性。方法:选取中国医科大学附属盛京医院心内科行冠状动脉(冠脉)造影的患者261例,其中冠心病组194例,造影结果排除冠心病者67例为对照组。应用Gensini评分系统对冠心病组患者冠脉病变程度进行定量评分,并将其分为3个亚组:低危组(Gensini评分<25分,68例),中危组(25分≤Gensini评分≤69分,72例),;高危组(Gensini评分>69分,54例)。比较4组患者一般临床资料及血清25-羟基维生素D(25-OHD)水平差异。应用Spearman检验分析病变程度与血清25-OHD、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)的相关性。应用logistic回归分析冠心病的独立危险因素。结果:冠心病组25-OHD水平低于正常水平,并低于对照组,差异有统计学意义(P<0.05);Gensini评分高危组患者血清25-OHD水平分别低于中危组及低危组患者,中危组血清25-OHD水平低于低危组患者,均差异有统计学意义(均P<0.05)。相关性分析显示,冠脉病变程度与血清25-OHD与HDL-C水平呈负相关(均P<0.05)。Logistic回归分析显示,血清25-OHD缺乏为冠心病的危险因素。结论:冠心病患者血清维生素D水平低于正常值,并明显低于非冠心病患者。血清维生素D水平越低,患者冠脉病变程度越重。血清维生素D缺乏为冠心病的危险因素,可能与冠心病的发生发展密切相关。

Objective:To explore the relationship between vitamin D and the occurrence and severity of coronary atherosclerotic heart disease.Methods:261 patients who underwent coronary angiography at the Department of Cardiology from Shengjing Hospital Affiliated to China Medical University were selected,including 194 patients with coronary heart disease(CHD group),and 67 cases without coronary heart disease(control group).All patients in the CHD group were divided into three subgroups according to the Gensini score:low-risk group(Gensini score<25 points,n=68),intermediate-risk group(25 points≤Gensini score≤69 points,n=72),high-risk group(Gensini score>69 points,n=54).General clinical data and 25-hydroxy-vitamin D(25-OHD)were compared among groups.Spearman analysis was used to analyze the correlation between the degree of coronary lesions and serum 25-OHD,low density lipoprotein(LDL-C),and high density lipoprotein(HDL-C).Logistic regression analysis was used to analyze the independent risk factors of coronary heart disease.Results:The 25-OHD level in the CHD group was lower than the normal level and lower than that in the control group(both P<0.05).In particular,the serum 25-OHD level in the high-risk group was lower than that in the intermediate-risk and middle-risk group,and the serum 25-OHD level in the medium risk group was lower than that in the low-risk group(all P<0.05).Correlation analysis showed that the degree of coronary artery disease was negatively correlated with serum 25-OHD level and HDL-C(P<0.05).Logistic regression analysis showed that serum 25-OHD deficiency was a risk factor for coronary heart disease.Conclusion:Serum vitamin D levels in patients with coronary heart disease are lower than the normal level and significantly lower than those in patients without coronary heart disease.The lower the level of serum vitamin D,the more severe the coronary artery disease.Serum vitamin D deficiency is a risk factor of coronary heart disease,which may be closely related to the occurrence and development of coronary heart disease.