维生素D与脑血管疾病的关系
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摘要
维生素D是一种类固醇衍生物,其经典生物效应是调节钙磷代谢。目前研究发现,维生素D具有保护血管内皮完整性、抗动脉粥样硬化、抗氧化应激、抗炎、抑制肾素-血管紧张素-醛固酮系统活性等作用。维生素D与缺血性脑卒中呈负相关,但与脑小血管疾病的关系尚不明确。本文通过综述维生素D与脑血管疾病的研究现状,以期为脑血管疾病的预防及治疗提供相关依据。
Vitamin D is a steroid derivative, whose classical biological effect is to regulate calcium and phosphorus metabolism. Studies up to date have found that it can protect the integrity of vascular endothelium, prevent atherosclerosis, and inhibit oxidative stress, inflammation and activity of renin-angiotensin-aldosterone system. Vitamin D is negatively correlated with ischemic stroke, but its relationship with cerebral small vessel diseases remains unclear. This article reviewed the status of the research on the relationship of vitamin D and cerebrovascular diseases in view of providing basis for the prevention and treatment of cerebrovascular diseases.
Vitamin D is a steroid derivative, whose classical biological effect is to regulate calcium and phosphorus metabolism. Studies up to date have found that it can protect the integrity of vascular endothelium, prevent atherosclerosis, and inhibit oxidative stress, inflammation and activity of renin-angiotensin-aldosterone system. Vitamin D is negatively correlated with ischemic stroke, but its relationship with cerebral small vessel diseases remains unclear. This article reviewed the status of the research on the relationship of vitamin D and cerebrovascular diseases in view of providing basis for the prevention and treatment of cerebrovascular diseases.
引文
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[4] Kunadian V,Ford GA,Bawamia B,et al.Vitamin D deficiency and coronary artery disease:a review of the evidence[J].Am Heart J,2014,167(3):283-291.DOI:10.1016/j.ahj.2013.11.012.
[5] 王思明,王欣越,董军,等.老年人血清25-羟基维生素D水平与亚临床动脉粥样硬化的关系[J].中华老年医学杂志,2016,35(11):1201-1205.DOI:10.3760/cma.j.issn.0254-9026.2016.11.015.Wang SM,Wang XY,Dong J,et al.Association between serum 25-hydroxyvitamin D levels and subclinical atherosclerosis in elderly people[J].Chin J Geriatr,2016,35(11):1201-1205.DOI:10.3760/cma.j.issn.0254-9026.2016.11.015.
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[7] Balden R,Selvamani A,Sohrabji F.Vitamin D deficiency exacerbates experimental stroke injury and dysregulates ischemia-induced inflammation in adult rats[J].Endocrinology,2012,153(5):2420-2435.DOI:10.1210/en.2011-1783.
[8] Pilz S,Tomaschitz A,Drechsler C,et al.Vitamin D supplementation:a promising approach for the prevention and treatment of strokes[J].Curr Drug Targets,2011,12(1):88-96.
[9] 关佳欣,高强,洪铭,等.维生素D和脑白质疏松症的研究进展[J].中华老年多器官疾病杂志,2017,16(9):708-711.DOI:10.11915/j.issn.16715403.2017.09.166.Guan JX,Gao Q,Hong M,et al.Research progress on relationship of vitamin D with leukoaraiosis[J].Chin J Mult Organ Dis Elderly,2017,16(9):708-711.DOI:10.11915/j.issn.16715403.2017.09.166.
[10] Soni M,Kos K,Lang IA,et al.Vitamin D and cognitive func-tion[J].Scand J Clin Lab Invest Suppl,2012,243:79-82.DOI:10.3109/00365513.2012.681969.
[11] Jiang P,Zhang LH,Cai HL,et al.Neurochemical effects of chronic administration of calcitriol in rats[J].Nutrients,2014,6(12):6048-6059.DOI:10.3390/nu6126048.
[12] De Silva DA,Talabucon LP,Ng EY,et al.Vitamin D deficiency and its relation to underlying stroke etiology in ethnic Asian ischemic stroke patients[J].Int J Stroke,2013,8(5):E18.DOI:10.1111/j.1747-4949.2012.00958.x.
[13] Leung RY,Han Y,Sing CW,et al.Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese[J].Thromb Haemost,2017,117(1):158-163.DOI:10.1160/TH16-07-0551.
[14] Schneider AL,Lutsey PL,Selvin E,et al.Vitamin D,vitamin D binding protein gene polymorphisms,race and risk of incident stroke:the Atherosclerosis Risk in Communities (ARIC) study[J].Eur J Neurol,2015,22(8):1220-1227.DOI:10.1111/ene.12731.
[15] Zhou R,Wang M,Huang H,et al.Lower vitamin D status is associated with an increased risk of ischemic stroke:a systematic review and meta-analysis[J].Nutrients,2018,10(3).pii:E277.DOI:10.3390/nu10030277.
[16] Sheerah HA,Eshak ES,Cui R,et al.Relationship between dietary vitamin D and deaths from stroke and coronary heart disease:the Japan collaborative cohort study[J].Stroke,2018,49(2):454-457.DOI:10.1161/STROKEAHA.117.019417.
[17] Nie Z,Ji XC,Wang J,et al.Serum levels of 25-hydroxyvitamin D predicts infarct volume and mortality in ischemic stroke patients[J].J Neuroimmunol,2017,313:41-45.DOI:10.1016/j.jneuroim.2017.10.002.
[18] Buell JS,Dawson-Hughes B,Scott TM,et al.25-hydroxyvitamin D,dementia,and cerebrovascular pathology in elders receiving home services[J].Neurology,2010,74(1):18-26.DOI:10.1212/WNL.0b013e3181beecb7.
[19] Turetsky A,Goddeau RP Jr,Henninger N.Low serum vitamin D is independently associated with larger lesion volumes after ischemic stroke[J].J Stroke Cerebrovasc Dis,2015,24(7):1555-1563.DOI:10.1016/j.jstrokecerebrovasdis.2015.03.051.
[20] Fu J,Xue R,Gu J,et al.Neuroprotective effect of calcitriol on ischemic/reperfusion injury through the NR3A/CREB pathways in the rat hippocampus[J].Mol Med Rep,2013,8(6):1708-1714.DOI:10.3892/mmr.2013.1734.
[21] Sultan M,Twito O,Tohami T,et al.Vitamin D diminishes the high platelet aggregation of type 2 diabetes mellitus patients[J].Platelets,2018,9:1-6.DOI:10.1080/09537104.2017.1386298.
[22] Zhang Y,Leung DY,Richers BN.Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1[J].J Immunol,2012,188(5):2127-2135.DOI:10.4049/jimmunol.1102412.
[23] Enkhjargal B,Malaguit J,Ho WM,et al.Vitamin D attenuates cerebral artery remodeling through VDR/AMPK/eNOS dimer phosphorylation pathway after subarachnoid hemorrhage in rats[J].J Cereb Blood Flow Metab,2019,39(2):272-284.DOI:10.1177/0271678X17726287.
[24] Topkoru BC,Altay O,Duris K,et al.Nasal administration of recombinant osteopontin attenuates early brain injury after subarachnoid hemorrhage[J].Stroke,2013,44(11):3189-3194.DOI:10.1161/STROKEAHA.113.001574.
[25] Shi Y,Wardlaw JM.Update on cerebral small vessel disease:a dynamic whole-brain disease[J].Stroke Vasc Neurol,2016,1(3):83-92.DOI:10.1136/svn-2016-000035.
[26] Chung PW,Park KY,Kim JM,et al.25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease[J].Stroke,2015,46(1):248-251.DOI:10.1161/STROKEAHA.114.007706.
[27] Carluccio MA,Di Donato I,Pescini F,et al.Vitamin D levels in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL)[J].Neurol Sci,2017,38(7):1333-1336.DOI:10.1007/s10072-017-2900-2.
[28] Feng C,Tang N,Huang H,et al.25-hydroxyvitamin D level is associated with total MRI burden of cerebral small vessel disease in ischemic stroke patients[J].Int J Neurosci,2018,22:1-6.DOI:10.1080/00207454.2018.1503182.
[29] Michos ED,Carson KA,Schneider AL,et al.Vitamin D and subclinical cerebrovascular disease:the atherosclerosis risk in communities brain magnetic resonance imaging study[J].JAMA Neurol,2014,71(7):863-871.DOI:10.1001/jamaneurol.2014.755.
[2] Zhu JG,Ochalek JT,Kaufmann M,et al.CYP2R1 is a major,but not exclusive,contributor to 25-hydroxyvitamin D production in vivo[J].Proc Natl Acad Sci USA,2013,110(39):15650-15655.DOI:10.1073/pnas.1315006110.
[3] 廖祥鹏,张增利,张红红,等.维生素D与成年人骨骼健康应用指南(2014年标准版)[J].中国骨质疏松杂志,2014,20(9):1011-1030.DOI:10.3969/j.issn.1006-7108.2014.09.002.Liao XP,Zhang ZL,Zhang HH,et al.Application guideline for vitamin D and bone health in adult Chinese(2014 standard edition)[J].Chin J Osteoporos,2014,20(9):1011-1030.DOI:10.3969/j.issn.1006-7108.2014.09.002.
[4] Kunadian V,Ford GA,Bawamia B,et al.Vitamin D deficiency and coronary artery disease:a review of the evidence[J].Am Heart J,2014,167(3):283-291.DOI:10.1016/j.ahj.2013.11.012.
[5] 王思明,王欣越,董军,等.老年人血清25-羟基维生素D水平与亚临床动脉粥样硬化的关系[J].中华老年医学杂志,2016,35(11):1201-1205.DOI:10.3760/cma.j.issn.0254-9026.2016.11.015.Wang SM,Wang XY,Dong J,et al.Association between serum 25-hydroxyvitamin D levels and subclinical atherosclerosis in elderly people[J].Chin J Geriatr,2016,35(11):1201-1205.DOI:10.3760/cma.j.issn.0254-9026.2016.11.015.
[6] Ni W,Watts SW,Ng M,et al.Elimination of vitamin D receptor in vascular endothelial cells alters vascular function[J].Hypertension,2014,64(4):1290-1298.DOI:10.1161/HYPERTENSIONAHA.114.03971.
[7] Balden R,Selvamani A,Sohrabji F.Vitamin D deficiency exacerbates experimental stroke injury and dysregulates ischemia-induced inflammation in adult rats[J].Endocrinology,2012,153(5):2420-2435.DOI:10.1210/en.2011-1783.
[8] Pilz S,Tomaschitz A,Drechsler C,et al.Vitamin D supplementation:a promising approach for the prevention and treatment of strokes[J].Curr Drug Targets,2011,12(1):88-96.
[9] 关佳欣,高强,洪铭,等.维生素D和脑白质疏松症的研究进展[J].中华老年多器官疾病杂志,2017,16(9):708-711.DOI:10.11915/j.issn.16715403.2017.09.166.Guan JX,Gao Q,Hong M,et al.Research progress on relationship of vitamin D with leukoaraiosis[J].Chin J Mult Organ Dis Elderly,2017,16(9):708-711.DOI:10.11915/j.issn.16715403.2017.09.166.
[10] Soni M,Kos K,Lang IA,et al.Vitamin D and cognitive func-tion[J].Scand J Clin Lab Invest Suppl,2012,243:79-82.DOI:10.3109/00365513.2012.681969.
[11] Jiang P,Zhang LH,Cai HL,et al.Neurochemical effects of chronic administration of calcitriol in rats[J].Nutrients,2014,6(12):6048-6059.DOI:10.3390/nu6126048.
[12] De Silva DA,Talabucon LP,Ng EY,et al.Vitamin D deficiency and its relation to underlying stroke etiology in ethnic Asian ischemic stroke patients[J].Int J Stroke,2013,8(5):E18.DOI:10.1111/j.1747-4949.2012.00958.x.
[13] Leung RY,Han Y,Sing CW,et al.Serum 25-hydroxyvitamin D and the risk of stroke in Hong Kong Chinese[J].Thromb Haemost,2017,117(1):158-163.DOI:10.1160/TH16-07-0551.
[14] Schneider AL,Lutsey PL,Selvin E,et al.Vitamin D,vitamin D binding protein gene polymorphisms,race and risk of incident stroke:the Atherosclerosis Risk in Communities (ARIC) study[J].Eur J Neurol,2015,22(8):1220-1227.DOI:10.1111/ene.12731.
[15] Zhou R,Wang M,Huang H,et al.Lower vitamin D status is associated with an increased risk of ischemic stroke:a systematic review and meta-analysis[J].Nutrients,2018,10(3).pii:E277.DOI:10.3390/nu10030277.
[16] Sheerah HA,Eshak ES,Cui R,et al.Relationship between dietary vitamin D and deaths from stroke and coronary heart disease:the Japan collaborative cohort study[J].Stroke,2018,49(2):454-457.DOI:10.1161/STROKEAHA.117.019417.
[17] Nie Z,Ji XC,Wang J,et al.Serum levels of 25-hydroxyvitamin D predicts infarct volume and mortality in ischemic stroke patients[J].J Neuroimmunol,2017,313:41-45.DOI:10.1016/j.jneuroim.2017.10.002.
[18] Buell JS,Dawson-Hughes B,Scott TM,et al.25-hydroxyvitamin D,dementia,and cerebrovascular pathology in elders receiving home services[J].Neurology,2010,74(1):18-26.DOI:10.1212/WNL.0b013e3181beecb7.
[19] Turetsky A,Goddeau RP Jr,Henninger N.Low serum vitamin D is independently associated with larger lesion volumes after ischemic stroke[J].J Stroke Cerebrovasc Dis,2015,24(7):1555-1563.DOI:10.1016/j.jstrokecerebrovasdis.2015.03.051.
[20] Fu J,Xue R,Gu J,et al.Neuroprotective effect of calcitriol on ischemic/reperfusion injury through the NR3A/CREB pathways in the rat hippocampus[J].Mol Med Rep,2013,8(6):1708-1714.DOI:10.3892/mmr.2013.1734.
[21] Sultan M,Twito O,Tohami T,et al.Vitamin D diminishes the high platelet aggregation of type 2 diabetes mellitus patients[J].Platelets,2018,9:1-6.DOI:10.1080/09537104.2017.1386298.
[22] Zhang Y,Leung DY,Richers BN.Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1[J].J Immunol,2012,188(5):2127-2135.DOI:10.4049/jimmunol.1102412.
[23] Enkhjargal B,Malaguit J,Ho WM,et al.Vitamin D attenuates cerebral artery remodeling through VDR/AMPK/eNOS dimer phosphorylation pathway after subarachnoid hemorrhage in rats[J].J Cereb Blood Flow Metab,2019,39(2):272-284.DOI:10.1177/0271678X17726287.
[24] Topkoru BC,Altay O,Duris K,et al.Nasal administration of recombinant osteopontin attenuates early brain injury after subarachnoid hemorrhage[J].Stroke,2013,44(11):3189-3194.DOI:10.1161/STROKEAHA.113.001574.
[25] Shi Y,Wardlaw JM.Update on cerebral small vessel disease:a dynamic whole-brain disease[J].Stroke Vasc Neurol,2016,1(3):83-92.DOI:10.1136/svn-2016-000035.
[26] Chung PW,Park KY,Kim JM,et al.25-hydroxyvitamin D status is associated with chronic cerebral small vessel disease[J].Stroke,2015,46(1):248-251.DOI:10.1161/STROKEAHA.114.007706.
[27] Carluccio MA,Di Donato I,Pescini F,et al.Vitamin D levels in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL)[J].Neurol Sci,2017,38(7):1333-1336.DOI:10.1007/s10072-017-2900-2.
[28] Feng C,Tang N,Huang H,et al.25-hydroxyvitamin D level is associated with total MRI burden of cerebral small vessel disease in ischemic stroke patients[J].Int J Neurosci,2018,22:1-6.DOI:10.1080/00207454.2018.1503182.
[29] Michos ED,Carson KA,Schneider AL,et al.Vitamin D and subclinical cerebrovascular disease:the atherosclerosis risk in communities brain magnetic resonance imaging study[J].JAMA Neurol,2014,71(7):863-871.DOI:10.1001/jamaneurol.2014.755.