中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2015年
1期
24-29
,共6页
心血管疾病%维生素D缺乏%动脉硬化%慢性肾脏病%肱踝脉搏波传导速度
心血管疾病%維生素D缺乏%動脈硬化%慢性腎髒病%肱踝脈搏波傳導速度
심혈관질병%유생소D결핍%동맥경화%만성신장병%굉과맥박파전도속도
Cardiovascular diseases%Vitamin D deficiency%Arteriosclerosis%Chronic kidney disease%Brachial ankle pulse wave velocity
目的 探讨慢性肾脏病患者维生素D缺乏与动脉僵硬度的相关性.方法 选取慢性肾脏病(CKD l～5期)患者300例,根据血25(OH)D3浓度分为维生素D缺乏组[25 (OH)D3＜20 μg/L]和维生素D非缺乏组[25(OH)D3≥20 μg/L].采集临床资料数据,测定动脉僵硬度指标肱踝脉搏波传导速度(baPWV).对血25(OH)D3水平与baPWV间的关系进行单因素相关分析及多元线性回归分析. 结果 维生素D缺乏组188例(62.7％),维生素D非缺乏组112例(37.3％).全部CKD患者25(OH)D3平均浓度为(17.62±8.54) μg/L,维生素D缺乏组和非缺乏组分别为(12.38±4.55) μg/L与(26.44±6.05) μg/L(P＜0.01).维生素D缺乏组baPWV值高于非缺乏组[(1 827.34±429.11) cm/s比(1 555.31±353.14) cm/s,P＜0.01].单因素相关分析显示全体CKD患者(r=-0.38,P＜0.01)以及CKD 2～5期患者[r=-0.30,P＜0.05;r=-0.26,P＜0.05;r=-0.46,P＜0.01;r=-0.57,P＜0.01]血25(OH)D3浓度与baPWV均呈负相关.多元线性回归分析显示血25 (OH)D3浓度下降与baPWV的增加独立相关(模型1:β=-0.18,P＜0.01;模型2:β=-0.17,P=0.01),回归模型1与模型2均可解释baPWV变化的50％.结论 CKD患者普遍存在维生素D缺乏,维生素D缺乏与动脉僵硬度增加相关.维生素D替代治疗可能影响CKD患者的心血管预后,但有待未来研究的进一步明确.
目的 探討慢性腎髒病患者維生素D缺乏與動脈僵硬度的相關性.方法 選取慢性腎髒病(CKD l～5期)患者300例,根據血25(OH)D3濃度分為維生素D缺乏組[25 (OH)D3＜20 μg/L]和維生素D非缺乏組[25(OH)D3≥20 μg/L].採集臨床資料數據,測定動脈僵硬度指標肱踝脈搏波傳導速度(baPWV).對血25(OH)D3水平與baPWV間的關繫進行單因素相關分析及多元線性迴歸分析. 結果 維生素D缺乏組188例(62.7％),維生素D非缺乏組112例(37.3％).全部CKD患者25(OH)D3平均濃度為(17.62±8.54) μg/L,維生素D缺乏組和非缺乏組分彆為(12.38±4.55) μg/L與(26.44±6.05) μg/L(P＜0.01).維生素D缺乏組baPWV值高于非缺乏組[(1 827.34±429.11) cm/s比(1 555.31±353.14) cm/s,P＜0.01].單因素相關分析顯示全體CKD患者(r=-0.38,P＜0.01)以及CKD 2～5期患者[r=-0.30,P＜0.05;r=-0.26,P＜0.05;r=-0.46,P＜0.01;r=-0.57,P＜0.01]血25(OH)D3濃度與baPWV均呈負相關.多元線性迴歸分析顯示血25 (OH)D3濃度下降與baPWV的增加獨立相關(模型1:β=-0.18,P＜0.01;模型2:β=-0.17,P=0.01),迴歸模型1與模型2均可解釋baPWV變化的50％.結論 CKD患者普遍存在維生素D缺乏,維生素D缺乏與動脈僵硬度增加相關.維生素D替代治療可能影響CKD患者的心血管預後,但有待未來研究的進一步明確.
목적 탐토만성신장병환자유생소D결핍여동맥강경도적상관성.방법 선취만성신장병(CKD l～5기)환자300례,근거혈25(OH)D3농도분위유생소D결핍조[25 (OH)D3＜20 μg/L]화유생소D비결핍조[25(OH)D3≥20 μg/L].채집림상자료수거,측정동맥강경도지표굉과맥박파전도속도(baPWV).대혈25(OH)D3수평여baPWV간적관계진행단인소상관분석급다원선성회귀분석. 결과 유생소D결핍조188례(62.7％),유생소D비결핍조112례(37.3％).전부CKD환자25(OH)D3평균농도위(17.62±8.54) μg/L,유생소D결핍조화비결핍조분별위(12.38±4.55) μg/L여(26.44±6.05) μg/L(P＜0.01).유생소D결핍조baPWV치고우비결핍조[(1 827.34±429.11) cm/s비(1 555.31±353.14) cm/s,P＜0.01].단인소상관분석현시전체CKD환자(r=-0.38,P＜0.01)이급CKD 2～5기환자[r=-0.30,P＜0.05;r=-0.26,P＜0.05;r=-0.46,P＜0.01;r=-0.57,P＜0.01]혈25(OH)D3농도여baPWV균정부상관.다원선성회귀분석현시혈25 (OH)D3농도하강여baPWV적증가독립상관(모형1:β=-0.18,P＜0.01;모형2:β=-0.17,P=0.01),회귀모형1여모형2균가해석baPWV변화적50％.결론 CKD환자보편존재유생소D결핍,유생소D결핍여동맥강경도증가상관.유생소D체대치료가능영향CKD환자적심혈관예후,단유대미래연구적진일보명학.
Objective To evaluate the association between serum 25-hydroxyvitamin D3 [25 (OH)D3] and arterial stiffness in patients with chronic kidney disease (CKD).Methods Three hundred patients with CKD were included,and were divided into two groups based on serum 25(OH)D3 levels:vitamin D deficient [25(OH)D3 ＜ 20 μg/L] and vitamin D non-deficient [25(OH)D3≥20 μg/L].Brachial ankle pulse wave velocity (baPWV),which reflected arterial stiffness,was calculated using the single-point method.Clinical data were collected in details.Correlation between serum 25(OH)D3 level and baPWV was assessed by the single factor correlation test and multiple linear regression analysis.Results The prevalence of vitamin D deficiency was 62.7％(188/300).The concentration of 25(OH)D3 was (17.62±8.54) μg/L in total patients,but was (12.38±4.55) μg/L and (26.44±6.05) μg/L in the subgroups of vitamin D deficient and non-deficient,respectively(P ＜ 0.01).There was a higher value of baPWV in the group of vitamin D deficient than that of vitamin D non-deficient (1 827.34±429.11 vs 1 555.31 ±353.14,P ＜ 0.01).Serum 25(OH)D3 level and baPWV was negatively correlated in total patients(r=-0.38,P ＜ 0.01) and each stage of CKD(stage 2-5)[r=-0.30,P ＜ 0.05; r=-0.26,P ＜ 0.05; r=-0.46,P ＜ 0.01; r=-0.57,P ＜ 0.01].Multiple linear regression analysis showed that vitamin D level was independently associated with baPWV(Model 1:β=-0.18,P ＜ 0.01; Model 2:β=-0.17,P=0.01).Both models accounted for 50％ (R2=0.50) of total variance of baPWV.Conclusions Vitamin D deficiency is common in CKD,and a low 25(OH)D3 level is significantly associated with increased arterial stiffness in these patients.Clinical intervention studies are needed to clarify whether treatment with vitamin D decreases the risk of cardiovascular disease in patients with CKD.
