Effect of cholecalciferol on local arterial stiffness and endothelial dysfunction in children with chronic kidney disease
Effect of cholecalciferol on local arterial stiffness and endothelial dysfunction in children with chronic kidney disease
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DOI：
10.1007/s00467-015-3220-5
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发表时间：
2016-02-01
影响因子：
3
通讯作者：
Ekinci, Zelal
中科院分区：
文献类型：
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作者：
Aytac, Mehmet Baha;Deveci, Murat;Ekinci, Zelal
由于心血管因素是慢性肾脏病（CKD）死亡的主要原因，并且由于维生素D缺乏症在这一人群中普遍存在，我们旨在研究口服胆钙化醇对CKD患儿心脏参数和内皮细胞活化生物标志物的影响。41名CKD患儿和24名无任何基础心脏或肾脏疾病且25-羟基维生素D3（25 OHD）水平低的健康受试者使用超声心动图评估基础和补充Stoss维生素D后的水平。比较各组的局部血管僵硬度和内皮功能障碍标志物，患者的初始血流介导的扩张（FMD）测量值较低，局部动脉僵硬度显著较高。在补充维生素D后，患者的这些症状显著改善，而健康组没有观察到显著变化。高同型半胱氨酸水平与维生素D水平呈负相关，血管性血友病因子是FMD损害的独立危险因素，我们的干预性研究显示大剂量胆钙化醇对心血管和内皮参数有良好的影响，提示补充维生素D在CKD儿童中的重要性。
As cardiovascular factors are the leading cause of mortality in chronic kidney disease (CKD) and as vitamin D deficiency is prevalent in this population, we aimed to examine the effect of oral cholecalciferol on cardiac parameters and biomarkers for endothelial cell activation in children with CKD.Forty-one children with CKD and 24 healthy subjects free of any underlying cardiac or renal disease with low 25-hydroxyvitamin D3 (25OHD) levels were evaluated using echocardiography basally and following Stoss vitamin D supplementation. The local vascular stiffness and endothelial dysfunction markers were compared among the groups.Initial flow-mediated dilatation (FMD) measurements were lower and local arterial stiffness was significantly higher in patients. After vitamin D supplementation, these improved significantly in patients, while no significant change was observed for the healthy group. Homocysteine showed inverse correlation with baseline vitamin D level in CKD children and von Willebrand factor emerged as an independent risk factor for FMD impairment.Our interventional study revealed the favorable effects of high-dose cholecalciferol on cardiovascular and endothelial parameters, implying the importance of vitamin D supplementation in children with CKD.