- 作者：Nihil Chitalia ; Alejandro Recio-Mayoral ; Juan Carlos Kaski ; Debasish Banerjee ; debasish.banerjee@stgeorges.nhs.uk
- 关键词：Vitamin D ; Chronic kidney disease ; Endothelial dysfunction
- 刊名：Atherosclerosis
- 出版年：2012
- 出版时间：January 2012
- 年：2012
- 卷：220
- 期：1
- 页码：265-268
- 全文大小：130 K
Background
Cardiovascular (CV) events are common in patients with chronic kidney disease (CKD) but inadequately explained by traditional risk factors. Vitamin D deficiency is highly prevalent in CKD and has been proposed to be a non-traditional risk factor, but its relationship with vascular function is unknown.Methods and results
The aim of this study was to investigate the relationship between vitamin D levels and endothelial function in non-diabetes patients with mild to moderate CKD. Endothelial function was measured non-invasively using brachial artery flow mediated dilation (FMD). 25 hydroxy vitamin D levels were measured using electrochemiluminescence immunoassay.
In 50 CKD patients (age 56 ¡À 11 years, BMI 25 ¡À 4 kg/m2, 46 % females, 14 % smokers, 86 % hypertensives, 52 % with dyslipidaemia) the mean vitamin D level was 53 ¡À 33 nmol/L (21 ¡À 13 ng/L). The mean FMD was 3.8 ¡À 2.4 % . Decreasing 25 hydroxy vitamin D levels were associated with decreasing FMD [r = 0.44, p = 0.001]. In multivariate analysis the association remained independent after adjustment with traditional risk factors (adjusted beta 0.451; t = 3.46; p < 0.002).
Patients with low vitamin D (?7.5 nmol/L) demonstrated low FMD compared to patients with vitamin D values >37.5 nmol/L (4.4 ¡À 2.5 % vs. 2.5 ¡À 1.6 % ; p = 0.007); however the traditional risk factors were similar between the two groups.
Conclusion
This is the first demonstration of an association of vitamin D deficiency with abnormal vascular endothelial function in non-dialysis CKD patients. Further studies with intervention and exploration of the mechanism are needed to establish a cause effect relationship.