Vitamin D in atherosclerosis, vascular disease, and endothelial function.
Vitamin D in atherosclerosis, vascular disease, and endothelial function.
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维生素 D 在动脉粥样硬化、血管疾病和内皮功能中的作用。
DOI：
10.2174/138945011793591617
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发表时间：
2011
影响因子：
3.2
通讯作者：
J. Reis
中科院分区：
文献类型：
--
作者：
LaPrincess C. Brewer;E. Michos;J. Reis
维生素D缺乏与高血压、糖尿病、充血性心力衰竭、外周动脉疾病、心肌梗死、中风和相关死亡的风险增加有关，即使在调整了传统的心血管危险因素后也是如此。从实验、临床和流行病学研究中积累的证据表明，维生素D也可能与血管功能的几个指标有关，包括动脉粥样硬化性心血管疾病的发生和发展。这些发现可能至少为最近的几项流行病学研究提供了部分解释，这些研究表明低维生素D状态与心血管疾病的发病机制有关。然而，许多问题仍然存在。目前只有几项研究可用，这些研究的结果总体上是喜忧参半的。此外，尚不清楚研究结果是否在不同的亚群中有所不同，包括美国的少数族裔亚群、年轻人以及居住在日照时间不同地区的人群。此外，维生素D影响动脉粥样硬化性疾病过程的确切机制尚未完全阐明。此外，如果维生素D在动脉粥样硬化的病因中起重要作用，目前尚不清楚维生素D在动脉粥样硬化疾病过程中的哪个阶段(S)可能发挥其作用。大规模的、进行良好的、安慰剂对照的临床试验测试维生素D补充剂在延缓、减缓或逆转动脉粥样硬化疾病过程中的有效性，目前还没有进行。在这些研究结果出来之前，我们认为推荐维生素D作为动脉粥样硬化的治疗选择还为时过早。
Vitamin D deficiency has been linked to an increased risk of hypertension, diabetes, congestive heart failure, peripheral arterial disease, myocardial infarction, stroke, and related mortality, even after adjustment for traditional cardiovascular risk factors. Accumulating evidence from experimental, clinical, and epidemiological studies suggests that vitamin D may also be associated with several indices of vascular function, including the development and progression of atherosclerotic cardiovascular disease. These findings may provide at least a partial explanation for several recent epidemiologic studies implicating low vitamin D status in the pathogenesis of cardiovascular disease. However, many questions still remain. Only a handful of studies are currently available, and the results of these studies have generally been mixed. Additionally, it is unknown whether findings differ across varied subpopulations, including minority subgroups in the United States, younger adults, and those residing in areas with varying amounts of regular sunlight. Furthermore, the exact mechanism by which vitamin D may influence the atherosclerotic disease process has not yet been completely elucidated. In addition, if vitamin D is important in the etiology of atherosclerosis, it is unclear at what stage(s) in the atherosclerotic disease process vitamin D may exert its effects. Large-scale, well-conducted, placebo controlled clinical trials testing the efficacy of vitamin D supplementation in delaying, slowing, or reverting the atherosclerotic disease process have not yet been conducted. Until the results of these studies are available, we believe it is premature to recommend vitamin D as a therapeutic option in atherosclerosis.