Mineral metabolism and arterial functions in end-stage renal disease:: Potential role of 25-hydroxyvitamin D deficiency
Mineral metabolism and arterial functions in end-stage renal disease:: Potential role of 25-hydroxyvitamin D deficiency
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DOI：
10.1681/asn.2006060573
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发表时间：
2007-02-01
影响因子：
13.6
通讯作者：
Metivier, Fabien
中科院分区：
文献类型：
--
作者：
London, Gerard M.;Guerin, Alain P.;Metivier, Fabien
在ESRD中，动脉功能异常，其特征是电容功能下降（动脉硬化）和导管功能降低，表现为血流介导的舒张（FMD）减弱。这些异常的病理生理学尚不清楚，本横断面研究通过测量血清25-羟基维生素D [25(OH)D-3]和1,25-二羟基维生素D-3 [1,25(OH)(2)D-3]水平，分析了动脉改变与心血管危险因素之间可能的关系，包括矿物质代谢参数，如血清甲状旁激素和维生素D“营养”和“激素”状态。对52例进行血液透析的稳定、无并发症患者进行主动脉僵硬度（脉搏波速度）、肱动脉（BA）扩张度（回声追踪，n = 42）、BA FMD（手温，n = 37）和动脉钙化评分（超声和x线平片）测量。25(OH)D-3和1,25(OH)(2)D-3低且呈弱相关（r = 0.365, P < 0.05）。校正血压和年龄后，多因素分析显示，25(OH) D-3和1,25(OH)(2)D-3与主动脉脉波速度呈负相关（P < 0.001），与BA扩张性（P < 0.01）和FMD呈正相关（P < 0.001）。动脉钙化评分与25(OH)D-3和1.25 (OH)(2)D血清浓度无独立相关性。这些结果表明，营养维生素D缺乏和低1,25(OH)(2)D-3可能与ESRD和血液透析患者的动脉硬化和内皮功能障碍有关。
In ESRD, arterial function is abnormal, characterized by decreased capacitive function (arterial stiffening) and reduced conduit function, shown by diminished flow-mediated dilation (FMD). The pathophysiology of these abnormalities is not clear, and this cross-sectional study analyzed possible relationships among arterial alterations and cardiovascular risk factors, including mineral metabolism parameters, such as serum parathormone, and vitamin D "nutritional" and "hormonal" status by measuring serum 25-hydroxyvitamin D [25(OH)D-3] and 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3] levels. Aortic stiffness (pulse wave velocity), brachial artery (BA) distensibility (echotracking; n = 42), BA FMD (hand-warming; n = 37), and arterial calcification scores (echography and plain x-rays) were measured in 52 stable and uncomplicated patients who were on hemodialysis. 25(OH)D-3 and 1,25(OH)(2)D-3 serum levels were low and weakly correlated (r = 0.365, P < 0.05). After adjustment for BP and age, multivariate analyses indicated that 25(OH)D-3 and 1,25(OH)(2)D-3 were negatively correlated with aortic pulse wave velocity (P < 0.001) and positively correlated with BA distensibility (P < 0.01) and FMD (P < 0.001). Arterial calcification scores were not independently associated with 25(OH)D-3 and 1,25(OH)(2)D, serum concentrations. These results suggest that nutritional vitamin D deficiency and low 1,25(OH)(2)D-3 could be associated with arteriosclerosis and endothelial dysfunction in patients who have ESRD and are on hemodialysis.