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维生素D缺乏,炎症和降低内源性再生能力在冠心病冠心病
Shivang R Desai1, Yi-An Ko1, Chang Liu2
1Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
JACC. Advances
|June 28, 2024
概括
冠状动脉心脏病 (CHD) 患者的维生素D缺乏与心血管死亡率的增加有关,特别是与炎症或原始细胞数量低结合时. 需要进一步的研究来确定有针对性的补充是否有利于这些高危人群.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 维生素D缺乏症 (VDD) 在患有冠状动脉心脏病 (CHD) 的患者中很普遍.
- VDD与心血管疾病的不良结果有关,可能是由于炎症和原始细胞功能受损.
- 目前的补充策略并不总是改善VDD的CHD患者的预后.
研究的目的:
- 为了研究VDD,炎症 (hsCRP) 和患有心脏病的患者的循环原生细胞 (CPC) 计数之间的关系.
- 确定VDD,炎症和降低的再生能力是否会导致心血管不良结果的风险增加.
- 在一个独立的患者队列中验证发现.
主要方法:
- 对25-基维生素D,hsCRP和CD34+CPC数量的分析,对5,452名心脏病患者进行了分析.
- 在独立的队列中验证发现.
- 使用Cox和Fine-Gray模型来评估与所有原因死亡率,心血管死亡率和主要心血管不良事件的关联.
主要成果:
- 在43.6%的个体中存在VDD,并与更高的调整心血管死亡率相关 (HR: 1.57).
- 在预测心血管死亡率方面,观察到VDD和hsCRP/CPC计数之间的显著相互作用.
- 患有VDD和高hsCRP (HR:2.82) 或VDD和低CPC计数 (HR:2.25) 的个体的风险最高.
结论:
- VDD是患有心血管疾病的患者不良结果的重要预测因素.
- 与炎症或降低再生能力相结合的VDD大大增加了心血管死亡风险.
- 在这些高风险人群中,向补充剂的有效性需要进一步研究.
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