Plasma 25-hydroxyvitamin D levels and risk of incident hypertension
Plasma 25-hydroxyvitamin D levels and risk of incident hypertension
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DOI：
10.1161/hypertensionaha.107.087288
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发表时间：
2007-05-01
期刊：
影响因子：
8.3
通讯作者：
Curhan, Gary C.
中科院分区：
文献类型：
--
作者：
Forman, John P.;Giovannucci, Edward;Curhan, Gary C.
25(OH)D 羟基化为 1,25-二羟基维生素 D 以及通过维生素 D 受体发出的信号发生在传统上不参与钙稳态的各种组织中。实验室研究表明，1,25-二羟基维生素 D 可抑制肾素表达和血管平滑肌细胞增殖；临床研究表明，紫外线辐射（维生素 D 合成的替代标记）与血压之间呈负相关。我们前瞻性地研究了测量的血浆 25-羟基维生素 D [25(OH)D] 水平与高血压发生风险之间的独立关联，以及预测的血浆 25(OH)D 水平与高血压发生风险之间的关联。两项前瞻性队列研究包括来自健康专业人员随访研究的 613 名男性和来自护士健康研究的 1198 名女性，测量了 25(OH)D 水平，随访时间为 4 至 8 年。此外，还对 2 项前瞻性队列研究进行了为期 16 至 18 年的随访，其中包括 38 388 名男性和 77 531 名女性，预测 25(OH) D 水平。在 4 年的随访期间，与血浆 25(OH)D 水平 >= 30 ng/mL 的男性相比，血浆 25(OH)D 水平 < 15 ng/mL（即维生素 D 缺乏）的男性发生高血压的多变量相对风险为 6.13（95% 置信区间 [CI]：1.00 至 37.8）。在女性中，同样的比较得出的相对风险为 2.67（95% CI：1.05 至 6.79）。使用随机效应模型测量的 25(OH)D 水平的男性和女性的汇总相对风险为 3.18（95% CI：1.39 至 7.29）。使用较大队列中预测的 25(OH)D 水平，比较最低和最高十分位的多变量相对风险在男性中为 2.31（95% CI：2.03 至 2.63），在女性中为 1.57（95% CI：1.44 至 1.72）。血浆 25(OH)D 水平与高血压发生风险呈负相关。
Hydroxylation of 25( OH) D to 1,25-dihydroxyvitamin D and signaling through the vitamin D receptor occur in various tissues not traditionally involved in calcium homeostasis. Laboratory studies indicate that 1,25-dihydroxyvitamin D suppresses renin expression and vascular smooth muscle cell proliferation; clinical studies demonstrate an inverse association between ultraviolet radiation, a surrogate marker for vitamin D synthesis, and blood pressure. We prospectively studied the independent association between measured plasma 25-hydroxyvitamin D [ 25( OH) D] levels and risk of incident hypertension and also the association between predicted plasma 25( OH) D levels and risk of incident hypertension. Two prospective cohort studies including 613 men from the Health Professionals' Follow-Up Study and 1198 women from the Nurses' Health Study with measured 25( OH) D levels were followed for 4 to 8 years. In addition, 2 prospective cohort studies including 38 388 men and 77 531 women with predicted 25( OH) D levels were followed for 16 to 18 years. During 4 years of follow-up, the multivariable relative risk of incident hypertension among men whose measured plasma 25( OH) D levels were < 15 ng/mL (ie, vitamin D deficiency) compared with those whose levels were >= 30 ng/mL was 6.13 (95% confidence interval [CI]: 1.00 to 37.8). Among women, the same comparison yielded a relative risk of 2.67 ( 95% CI: 1.05 to 6.79). The pooled relative risk combining men and women with measured 25( OH) D levels using the random-effects model was 3.18 ( 95% CI: 1.39 to 7.29). Using predicted 25( OH) D levels in the larger cohorts, the multivariable relative risks comparing the lowest to highest deciles were 2.31 ( 95% CI: 2.03 to 2.63) in men and 1.57 ( 95% CI: 1.44 to 1.72) in women. Plasma 25( OH) D levels are inversely associated with risk of incident hypertension.