高龄高血压患者血清维生素D3与外周动脉硬化的相关性分析

Correlation of serum vitamin D3 level with peripheral arterial sclerosis in very old patients with hypertension

摘要:

目的 探讨高龄高血压患者血清维生素D3水平与外周动脉硬化的相关性。方法 入选2011年9月至2012年11月在北京友谊医院老年科住院的高龄老年高血压患者166例,年龄75～99(85.5±4.9)岁。以血清25-羟基维生素D3[25(OH)D3]＜20 ng/ml作为维生素D3缺乏的诊断标准,将患者分为维生素D3缺乏组(n=118)和维生素D3正常组(n=48)。动态血压及下肢动脉超声结果反映外周动脉硬化程度,分析维生素D3缺乏和外周动脉硬化的相关性。采用SPSS 16.0软件对数据进行统计分析。计量资料用均数±标准差 ([AKx-D]±s) 表示,两组比较采用t检验。计数资料用百分率表示,组间比较用χ²检验。Logistic回归分析下肢动脉狭窄的相关危险因素。结果 相比维生素D3水平正常组,维生素D3缺乏组患者的LDL-C水平高,舒张压更低,脉压更大,高脂血症和外周动脉硬化发病率高,差异具有统计学意义(P＜0.05)。Logistic回归分析结果表明下肢动脉狭窄与维生素D3水平(OR=0.780,95%CI 0.670~0.890; P=0.039)、舒张压水平负相关(OR=1.030,95%CI 0.929~0.983; P=0.040),而与LDL-C水平正相关(OR=2.446,95%CI 1.138~1.312; P=0.043)。结论 高龄高血压患者血清维生素D3缺乏与外周动脉硬化有明显相关性。

Abstract:

Objective To analyze the correlation of serum vitamin D3 level with peripheral arterial sclerosis (PAS) in the very old patients with hypertension. Methods A total of 166 very old patients with primary hypertension (85.5±4.9 years old, 75-99) admitted in our department from September 2011 to November 2012 were enrolled in this study. With serum 25(OH)D3 level lower than 20 ng/ml as diagnostic criteria for vitamin D3 deficiency, these patients were divided into low level group (n=118) and normal group (n=48). Ambulatory 24-hour blood pressure monitoring and lower extremity arteries ultrasonography were performed to evaluate the severity of PAS. The correlation between serum vitamin D3 level and PAS severity was analyzed. SPSS statistics 16.0 was employed for data analysis. The measurement data were expressed as mean±standard deviation ([AKx-D]±s), and Student’s t test was employed for the comparison between groups. Enumeration data were expressed as percentage, and inter-group comparison was carried out with Chi-square test. Related risk factors of lower extremity arterial stenosis were analyzed by logistic regression analysis. Results Compared with the normal group, the low level group had higher level of low-density lipoprotein cholesterol (LDL-C), lower diastolic blood pressure (DBP), higher pulse pressure, and higher incidences of PSA and hyperlipidemia (P<0.05). The results of logistic regression analysis showed that PAS was negatively correlated with serum 25(OH)D3(OR=0.780,5%CI 0.670-0.890; P=0.039) and DBP(OR=1.030,5%CI 0.929-0.983; P=0.040), but positively correlated with LDL-C (OR=2.446,5%CI 1.138-1.312; P=0.043). Conclusion Serum vitamin D3 level is in obvious correlation with PAS in the very old patients with hypertension.