血清25-羟基维生素D水平与老年脑小血管病变相关性研究
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摘要
目的探讨血清25-羟基维生素D[血清25(OH)D]水平与老年脑小血管病变的相关性。方法回顾性分析北部战区总医院2015—2016年收治的163例腔隙性脑梗死患者(腔隙性脑梗死组)、120例脑白质病变患者(脑白质病变组)及158例同年龄段健康体检者(健康组)的临床资料,比较3组研究对象的血清25(OH)D水平,记录3组研究对象血清25(OH)D充足、缺乏、不足的比例,并进行血清25(OH)D与腔隙性脑梗死、脑白质病变的相关性分析。结果腔隙性脑梗死组血清25(OH)D缺乏患者比例高于健康组(43.6%比23.4%),脑白质病变组血清25(OH)D缺乏患者比例高于健康组(39.2%比23.4%),差异均有统计学意义(P<0.05)。血清25(OH)D水平每降低10 ng/ml时,腔隙性脑梗死组回归系数为0.24(95%可信区间为0.03～0.48,P<0.05),脑白质病变组比值比为2.11(95%可信区间为1.50～3.26,P<0.05);血清25(OH)D缺乏时,腔隙性脑梗死组回归系数为0.53(95%可信区间为0.05～0.89,P<0.05),脑白质病变组比值比为2.85(95%可信区间为1.28～6.32,P<0.05)。结论血清25(OH)D水平与老年腔隙性脑梗死和脑白质病变显著相关,可通过监测血清25(OH)D水平预防腔隙性脑梗死和脑白质病变发生。
Objective To investigate the correlation between serum 25-hydroxyvitamin D[serum 25(OH)D]and cerebrovascular disease in elderly patients.Methods A retrospective study was performed on 163 cases of patients with lacunar infarction(lacunar group),120 cases of patients with white matter lesion(white matter lesion) and 158 cases of volunteers that took the healthy examination(healthy group) were admitted from 2015 to 2016.Serum 25(OH)D levels of the subjects in the three groups were compared,and the proportion of the subjects in the three groups with sufficient,deficient and insufficient serum 25(OH)D was recorded,and the correlation analysis of serum 25(OH)D with lacunar infarction and white matter lesions was analyzed.Results The proportion of patients with serum 25(OH)D deficiency in the lacunar infarction group was higher than that in the healthy group(43.6% versus 23.4%),and the proportion of patients with serum 25(OH)D deficiency in the white matter lesion group was higher than that in the healthy group(39.2% versus 23.4%),with statistically significant differences(P<0.05).When serum 25(OH)D level was reduced by 10 ng/ml,the regression coefficient of lacunar infarction group was 0.24(95%CI was 0.03-0.48,P<0.05),and the ratio of white matter lesion group was 2.11(95%CI was 1.50-3.26,P<0.05).In serum 25(OH)D deficiency,the regression coefficient of lacunar infarction group was 0.53(95%CI was 0.05-0.89,P<0.05),and the ratio of white matter lesion group was 2.85(95%CI was 1.28-6.32,P<0.05).Conclusion Serum 25(OH)D level was significantly correlated with lacunar infarction and white matter lesions in the elderly patients,and lacunar infarction and white matter lesions could be prevented by monitoring serum 25(OH)D level.
Objective To investigate the correlation between serum 25-hydroxyvitamin D[serum 25(OH)D]and cerebrovascular disease in elderly patients.Methods A retrospective study was performed on 163 cases of patients with lacunar infarction(lacunar group),120 cases of patients with white matter lesion(white matter lesion) and 158 cases of volunteers that took the healthy examination(healthy group) were admitted from 2015 to 2016.Serum 25(OH)D levels of the subjects in the three groups were compared,and the proportion of the subjects in the three groups with sufficient,deficient and insufficient serum 25(OH)D was recorded,and the correlation analysis of serum 25(OH)D with lacunar infarction and white matter lesions was analyzed.Results The proportion of patients with serum 25(OH)D deficiency in the lacunar infarction group was higher than that in the healthy group(43.6% versus 23.4%),and the proportion of patients with serum 25(OH)D deficiency in the white matter lesion group was higher than that in the healthy group(39.2% versus 23.4%),with statistically significant differences(P<0.05).When serum 25(OH)D level was reduced by 10 ng/ml,the regression coefficient of lacunar infarction group was 0.24(95%CI was 0.03-0.48,P<0.05),and the ratio of white matter lesion group was 2.11(95%CI was 1.50-3.26,P<0.05).In serum 25(OH)D deficiency,the regression coefficient of lacunar infarction group was 0.53(95%CI was 0.05-0.89,P<0.05),and the ratio of white matter lesion group was 2.85(95%CI was 1.28-6.32,P<0.05).Conclusion Serum 25(OH)D level was significantly correlated with lacunar infarction and white matter lesions in the elderly patients,and lacunar infarction and white matter lesions could be prevented by monitoring serum 25(OH)D level.
引文
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[14] Buell JS,Dawson-Hughes B,Scott TM,et al.25-Hydroxyvitamin D,dementia,and cerebrovascular pathology inelders receiving home services[J].Neurology,2010,74:18-26.
[15] Chung PW,Park KY,Kim JM,et al.Carotid artery calcificationis associated with deep cerebral microbleeds[J].Eur Neurol,2014,72:60-63.
[2] Fisher CM.Capsular infarcts:the underlying vascular lesions[J].Arch Neurol,1979,36(2):65-73.
[3] Moody DM,Brown WR,Challa VR,et al.Periventricular venouscollagenosis:association with leukoaraiosis[J].Radiology,1995,194(2):469-476.
[4] van den Bergh R.Centrifugal elements in the vascular pattern of the deep intracerebral blood supply[J].Angiologica,1969,20(2):88-94.
[5] Chester EM,Agamanolis DP,Banker Q,et al.Hypertensiveencephalopathy:a clinicopathologic study of 20 cases[J].Neurology,1978,28(9 Pt 1):928-939.
[6] 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.
[7] 宋笑凯,李淮玉,任明山.25-羟基维生素D与脑梗死的关系及干预治疗的临床研究[J].中国卒中杂志,2015,10(3):231-237.
[8] Holick MF,Binkley NC,Bischoff-Ferrari HA,et al.Evaluation,treatment and prevention of vitamin D deficiency[J].J Clin Endocrinol Metab,2011,96:1911-1930.
[9] Straube S,Derry S,Moore RA,et al.Vitamin D for the treatment of chronic painful conditions in adults[J].Cochrane Database Syst Rev,2015,6(5):CD007771.
[10] Cantorna MT,Snyder L,Lin YD,et al.Vitamin D and 1,25(OH)2D regulation of T cells[J].Nutrients,2015,7(4):3011-3021.
[11] Hewison M,Zehnder D,Chakraverty R,et al.Vitamin D and barrier function:a novel role for extra-renal 1 alpha-hydroxylase[J].Mol Cell Endocrinol,2004,215:31-38.
[12] Elfakhri N,Mcdevitt H,Shaikh MG,et al.Vitamin D and its effects on glucose homeostasis,cardiovascular function and immune function[J].Horm Res Paediatr,2014,81(6):363-378.
[13] Jeng L,Yamshchikov AV,Judd SE,et al.Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis[J].J Transl Med,2009,7(1):28-37.
[14] Buell JS,Dawson-Hughes B,Scott TM,et al.25-Hydroxyvitamin D,dementia,and cerebrovascular pathology inelders receiving home services[J].Neurology,2010,74:18-26.
[15] Chung PW,Park KY,Kim JM,et al.Carotid artery calcificationis associated with deep cerebral microbleeds[J].Eur Neurol,2014,72:60-63.