The role of vitamin D in left ventricular hypertrophy and cardiac function
The role of vitamin D in left ventricular hypertrophy and cardiac function
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DOI：
10.1111/j.1523-1755.2005.09506.x
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发表时间：
2005-06-01
影响因子：
19.6
通讯作者：
Ayus, JC
中科院分区：
文献类型：
--
作者：
Achinger, SG;Ayus, JC
维生素D在左心室肥厚和心功能中的作用。心血管疾病是终末期肾病（ESRD）患者死亡的主要原因。传统的心脏风险因素以及ESRD人群特有的其他因素，如高磷酸盐血症、钙和磷酸盐产物升高、脂质代谢异常、高同型半胱氨酸血症和慢性炎症，在该人群的心血管死亡风险过高中发挥作用。左心室疾病是血液透析患者心源性死亡的危险因素。这些疾病在ESRD患者中的发病率远高于一般人群。越来越多的证据表明，维生素D在心血管疾病中发挥作用。已证明，由于缺乏活性形式的1，25-二羟维生素D-3而导致的维生素代谢异常以及通过尿毒症状态获得的维生素D抵抗在ESRD中很重要。维生素D缺乏长期以来被认为会影响心脏收缩力、血管张力、心脏胶原蛋白含量和心脏组织成熟。最近使用维生素D受体缺陷小鼠作为模型的研究证明了维生素D在调节肾素-血管紧张素系统中的关键作用。此外，有新的证据表明，维生素D治疗可改善血液透析的生存率和心脏功能。这一数据的出现使人们的注意力集中在以前未被充分认识的维生素D的非矿物质稳态作用上，这种作用很可能在ESRD心脏病的发病机制中发挥重要作用。
The role of vitamin D in left ventricular hypertrophy and cardiac function. Cardiovascular disease is the leading cause of death among patients with end-stage renal disease (ESRD). Traditional cardiac risk factors, as well as other factors specific to the ESRD population such as hyperphosphatemia, elevated calcium and phosphate product, abnormal lipid metabolism, hyperhomocysteinemia, and chronic inflammation play a role in the excessive risk of cardiovascular death in this population. Left ventricular disorders are proven risk factors for cardiac mortality in hemodialysis patients. These disorders are present in incident ESRD patients at rates far above the general population. There is an accumulating body of evidence that suggests that vitamin D plays a role in cardiovascular disease. Abnormal vitamin metabolism, through deficiency of the active form of 1,25-dihydroxyvitamin D-3, and acquired vitamin D resistance through the uremic state, have been shown to be important in ESRD. Vitamin D deficiency has long been known to affect cardiac contractility, vascular tone, cardiac collagen content, and cardiac tissue maturation. Recent studies using vitamin D receptor deficient mice as a model demonstrate a crucial role of vitamin D in regulation of the renin-angiotensin system. Additionally, there is emerging evidence linking treatment with vitamin D to improved survival on hemodialysis and improvement in cardiac function. The emergence of this data is focusing attention on the previously underappreciated nonmineral homeostatic effects of vitamin D that very likely play an important role in the pathogenesis of cardiac disease in ESRD.