血清25-羟基维生素D与血脂、脂蛋白胆固醇和同型半胱氨酸之间的关系。

Charles J Glueck, Vybhav Jetty, Matan Rothschild, Gregory Duhon, Parth Shah, Marloe Prince, Kevin Lee, Michael Goldenberg, Ashwin Kumar, Naila Goldenberg, Ping Wang
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引用次数: 45

摘要

背景:血清25(OH)维生素D水平与心血管疾病(CVD)死亡率呈负相关,部分与高密度脂蛋白胆固醇(HDLC)呈正相关,与低密度脂蛋白胆固醇(LDLC)、甘油三酯和同型半胱氨酸呈负相关。目的:在这项研究中,我们评估了空腹血清维生素D与血脂、脂蛋白胆固醇和同型半胱氨酸之间的关系。材料与方法:我们对2007年至2016年依次转介到本中心的1534例患者进行了研究。测定空腹血清总25(OH)维生素D、血浆胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白和同型半胱氨酸。采用逐步回归模型,以总胆固醇、甘油三酯、HDLC、LDLC和同型半胱氨酸作为因变量和解释变量,年龄、种族、性别、体重指数(BMI)和血清维生素D水平。在对年龄、种族、性别和BMI进行协方差调整后,评估血清维生素D与甘油三酯、高密度脂蛋白、低密度脂蛋白和同型半胱氨酸之间的关系。结果:空腹血清维生素D与年龄、HDLC、白种人呈正相关,与BMI、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹血清同型半胱氨酸呈负相关(均P≤0.0001)。血清维生素D是总胆固醇、甘油三酯和低密度脂蛋白胆固醇的显著独立负相关解释变量,对血清总胆固醇(偏R(2) =3.6%)、甘油三酯(偏R(2) =3.1%)和低密度脂蛋白(偏R(2) =2.9%)的方差最大(均P < 0.0001)。血清维生素D是HDLC的显著正解释变量(偏R (2) = 1.4%, P < 0.0001),是同型半胱氨酸的显著负解释变量(偏R(2) = 6.0-12.6%)。结论:在高脂血症患者中,血清维生素D是总胆固醇、低密度脂蛋白、甘油三酯和同型半胱氨酸的显著独立负相关决定因素,也是HDLC的显著独立阳性决定因素。因此,血清维生素D可能对心血管疾病有保护作用。
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Associations between Serum 25-hydroxyvitamin D and Lipids, Lipoprotein Cholesterols, and Homocysteine.

Background: Serum 25(OH) vitamin D levels are inversely associated with cardiovascular disease (CVD) mortality, mediated in part by independent positive relationships with high-density lipoprotein cholesterol (HDLC) and inverse relationships with low-density lipoprotein cholesterol (LDLC), triglyceride, and homocysteine.

Aims: In this study, we assessed relationships between fasting serum vitamin D and lipids, lipoprotein cholesterols, and homocysteine.

Materials and methods: We studied 1534 patients sequentially referred to our center from 2007 to 2016. Fasting serum total 25(OH) vitamin D, plasma cholesterol, triglyceride, HDLC, LDLC, and homocysteine were measured. Stepwise regression models were used with total cholesterol, triglyceride, HDLC, LDLC, and homocysteine as dependent variables and explanatory variables age, race, gender, body mass index (BMI), and serum vitamin D levels. Relationships between quintiles of serum vitamin D and triglycerides, HDLC, LDLC, and homocysteine were assessed after covariance adjusting for age, race, gender, and BMI.

Results: Fasting serum vitamin D was positively correlated with age, HDLC, and White race, and was inversely correlated with BMI, total and LDL cholesterol, triglyceride, and fasting serum homocysteine (P ≤ 0.0001 for all). Serum vitamin D was a significant independent inverse explanatory variable for total cholesterol, triglyceride, and LDL cholesterol, and accounted for the largest amount of variance in serum total cholesterol (partial R (2) =3.6%), triglyceride (partial R (2) =3.1%), and LDLC (partial R (2) =2.9%) (P < 0.0001 for all). Serum vitamin D was a significant positive explanatory variable for HDLC (partial R (2) = 1.4%, P < 0.0001), and a significant inverse explanatory variable for homocysteine (partial R (2) = 6.0-12.6%).

Conclusions: In hyperlipidemic patients, serum vitamin D was a significant independent inverse determinant of total cholesterol, LDLC, triglyceride, and homocysteine, and a significant independent positive determinant of HDLC. Thus, serum vitamin D might be protective against CVD.

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