维生素D缺乏与高血压的相关性研究进展

Research progress on the correlation between vitamin D deficiency and hypertension

高血压是一种常见的心血管疾病,致残率、致死率均较高。维生素D是人体所必须的营养成分,能提高机体对Ca2+的吸收,从而进一步促进Ca2+沉积。维生素D缺乏会引起一系列疾病。机体中的7-脱氢胆甾醇会转化为维生素D3,转运至肝脏中,在羟化酶作用下转化为25-羟维生素D[25(OH)D],结合蛋白到达肾脏部位,之后在1α-羟化酶作用下,生成骨化三醇(1,25-二羟维生素D),其可结合维生素D受体(一类配体依赖核转录因子),从而起到生物学效应,进而对基因转录产生影响。维生素D缺乏引起高血压疾病的可能机制包括:激活肾素-血管紧张素-醛固醇系统(RAAS)、甲状旁腺功能,影响机体的血管内皮细胞功能、增加胰岛素抵抗、上调一氧化氮合成酶、影响血管平滑肌细胞功能、血管动脉粥样硬化、钙化以及遗传基因。对于高血压人群,补充维生素D制剂能改善患者的不良心血管事件发生率,而补充维生素D对心血管死亡率研究较缺乏大样本量深入分析,因此临床上有待更多的试验数据进行深入研究。本文对维生素D缺乏与高血压的相关性研究进展进行综述,以期为高血压的治疗提供帮助。

Hypertension is a common cardiovascular disease,the disability and mortality rates are both relatively high.Vitamin D is an essential nutrient for the human body,which can increase the body's absorption of Ca?+,thus further promote the Ca2+deposition.Vitamin D deficiency can lead to a series of the diseases.The 7-dehydrogenation cholesteryl in the body is converted into vitamin Ds,which is transported to the liver,under the action of hydroxylase convertes into 25-hydroxyl vitamin D[25(OH)D],combines with the protein,then it reaches the kidney,after in the role of 1 alpha hydroxylase,generates calcitriol(1,25-dihydroxy vitamin D),it can be combined with vitamin D receptor(a class of ligands relying on nuclear transcription factor),thus plays a biological effect,and then affects gene transcription.The possible mechanism by which vitamin D deficiency causes hypertension disease includes:activate the renin-angiotensin-aldosterone system(RAAS)and parathyroid function,affect the body's vascular endothelial cell function,increase the insulin resistance,increase of nitric oxide synthase,affect function of vascular smooth muscle cells,vascular sclerosis of arterial congee appearance and calcification,genetic genes.For hypertensive population,vitamin D supplementation can improve the incidence of adverse cardiovascular events of patients.However,the study on cardiovascular mortality of vitamin D supplementation lacks in-depth analysis with large sample size,so more clinical trial data are needed for in-depth study.This article reviews the research progress on the correlation between vitamin D deficiency and hypertension,in order to provide assistance for the treatment of hypertension.