Exploration of Association of 1,25-OH2D3 with Augmentation Index, a Composite Measure of Arterial Stiffness
Exploration of Association of 1,25-OH2D3 with Augmentation Index, a Composite Measure of Arterial Stiffness
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DOI：
10.2215/cjn.00900208
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发表时间：
2008-11-01
影响因子：
9.8
通讯作者：
Levin, Adeera
中科院分区：
文献类型：
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作者：
Andrade, Jason;Er, Lee;Levin, Adeera
背景和目标：矿物质代谢[钙、磷酸盐和免疫反应性甲状旁腺激素（PTH）]和维生素D的异常与中心动脉僵硬度的增加有关。中心动脉硬度可以使用无创技术测量，包括增强指数（AIx），动脉硬度的复合测量。设计，设置，参与者和测量：在131名来自心脏病或肾脏病诊所的门诊患者中，我们检查了传统的人口统计学和实验室危险因素，维生素D水平，（1，25-OH 2D 3和25-OHD 3）以及与Alx相关的炎症或内皮功能标志物[C反应肽（hsCRP）、基质金属蛋白酶2（MMP-2）、基质金属蛋白酶9（MMP-9）和IL-6]。不同诊所之间的中位eGFR存在显著差异（范围为25-81 ml/min）。磷酸盐或MMP-9水平较高的受试者AN较高（分别为P = 0.02和0.07）。较低的1，25-OH 2D 3水平或降低的eGFR与较高的AIx相关（分别为P = 0.002和0.005）。在正常范围内观察到1，25-OH 2D 3与磷酸盐水平和AN之间的相关性。未发现钙、iPTH、25-OHD 3或hsCRP与AIx相关。调整潜在的混杂因素[eGFR，钙，磷酸盐，和（log）iPTH]的关联较低的1，25-OH 2D 3与ANstatistically significant.Conclusion：这项探索性研究表明，AN和1，25-OH 2D 3之间的显着关联在一个不同的组与心脏，肾脏疾病，或两者兼而有之。这些对维生素D在血管健康中作用的日益了解为这些发现提供了背景，并提出了关于复杂患者中其他可改变的风险因素的问题。需要进一步研究。
Background and objectives: Abnormalities in mineral metabolism [calcium, phosphate, and immunoreactive parathyroid hormone (PTH)] and vitamin D have been linked to increases in central arterial stiffness. Central arterial stiffness can be measured using noninvasive technologies, including augmentation index (AIx), a composite measure of arterial stiffness.Design, setting, participants, and measurements: In 131 outpatients identified from individual cardiac or kidney disease clinics, we examined conventional demographic and laboratory risk factors, vitamin D levels (1,25-OH2D3 and 25-OHD3), and markers of inflammation or endothelial function [C-reactive peptide (hsCRP), matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), and IL-6] in relationship to Alx.Results: The median eGFR was significantly different between clinics (range 25-81 ml/min). Subjects with higher phosphate or MMP-9 levels were found to have a higher AN (P = 0.02 and 0.07, respectively). Lower 1,25-OH2D3 levels or reduced eGFR were associated with higher AIx (P = 0.002 and 0.005, respectively). The associations between 1,25-OH2D3 and phosphate levels and AN were observed for values within the normal range. No association was noted for calcium, iPTH, 25-OHD3, or hsCRP and AIx. Adjusting for potential confounders [eGFR, calcium, phosphate, and (log) iPTH] the association of lower 1,25-OH2D3 with AN remained statistically significant.Conclusion: This exploratory study demonstrates a significant association between AN and 1,25-OH2D3 in a diverse group with cardiac, kidney disease, or both. These increasing understanding of the role of vitamin D in vascular health lends a context to these findings and raises questions as to additional modifiable risk factors in complex patients. Further studies are required.