Eur Heart J：25-羟维生素D水平与严重心脑血管事件相关

2013-01-22 Eur Heart J CMT 高晓方 编译

25-羟维生素D水平严重心脑血管事件

　　德国学者的一项研究表明，在心脏手术患者中25-羟维生素D[25(OH)D]缺乏常见，并且与严重心脑血管事件（MACCE）风险呈独立相关。论文于2013年1月12日在线发表于《欧洲心脏杂志》（Eur Heart J）。 　　此项研究共纳入4418例行心脏手术治疗的序贯患者；其中25(OH)D缺乏（<30 nmol/L）和不足（30～49.9 nmo

　　德国学者的一项研究表明，在心脏手术患者中25-羟维生素D[25(OH)D]缺乏常见，并且与严重心脑血管事件（MACCE）风险呈独立相关。论文于2013年1月12日在线发表于《欧洲心脏杂志》（Eur Heart J）。

　　此项研究共纳入4418例行心脏手术治疗的序贯患者；其中25(OH)D缺乏（<30 nmol/L）和不足（30～49.9 nmol/L）的患者分别为38.0%和32.3%，25(OH)D >100 nmol/L的患者仅为3.1%。

　　结果显示，MACCE发生率为11.5%。在多变量校正Logistic回归模型中，与25(OH)D为75～100 nmol/L的患者相比，25(OH)D缺乏、不足和充足者的MACCE比值比分别为2.23、1.73和2.34。25(OH)D与机械通气和ICU住院时间亦呈U型相关。与25(OH)D为75～100 nmol/L的患者相比，25(OH)D缺乏患者的多变量校正6和12个月死亡率较高。


Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery

Aims A significant proportion of cardiac surgical patients develop critical post-operative complications. We aimed to investigate the association of pre-operative 25-hydroxyvitamin D (25(OH)D) levels with major cardiac and cerebrovascular events (MACCE) in cardiac surgical patients.

Methods and results From January 2010 to August 2011, we consecutively measured circulating 25(OH)D in 4418 operated patients. Of the study cohort, 38.0% had deficient 25(OH)D values (<30 nmol/L) and additional 32.3% had insufficient values (30–49.9 nmol/L), whereas only 3.1% had values >100 nmol/L. The incidence of MACCE was 11.5%. In multivariable-adjusted logistic regression models, the odds ratio of MACCE at deficient, inadequate, and high 25(OH)D levels was 2.23 [95% confidence interval (CI): 1.31–3.79], 1.73 (95% CI: 1.01–2.96) and 2.34 (95% CI: 1.12–4.89), respectively, compared with 25(OH)D levels of 75–100 nmol/L. A U-shaped association with circulating 25(OH)D was also present for duration of mechanical ventilatory support and intensive care unit stay. Multivariable-adjusted 6- and 12-month mortality were higher in patients with deficient 25(OH)D levels compared with patients with 25(OH)D levels of 75–100 nmol/L.

Conclusion Deficient 25(OH)D levels are prevalent in cardiac surgical patients in Central Europe and are independently associated with the risk of MACCE. Further research should clarify the potential of vitamin D supplements in reducing cardiovascular risk in vitamin D-deficient patients and also the mechanisms leading to adverse effects on the cardiovascular system in the small group of patients with 25(OH)D levels >100 nmol/L.


    

作者：Eur Heart J



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