Vitamin D deficiency in persons over 50 years of age with and without carotid artery atherosclerosis: a cross-sectional outpatient study

L. V. Mikhailova, M. A. Kovalenko, L. Litvinova, N. D. Gazatova, M. Vulf
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Abstract

Highlights. The association between vitamin D levels and estimated glomerular filtration rate and triglyceride levels was revealed in people with cardiovascular risk factors aged older than 50 years. Vitamin D deficiency was more frequently noted in patients with acute coronary syndrome. They also were more likely to have abdominal obesity and type 2 diabetes mellitus, indicating the association between vitamin D deficiency and metabolic syndrome. The high prevalence of both vitamin D deficiency and metabolic syndrome in the population necessitates further larger-scale studies to identify the relationship between vitamin D levels and cardiovascular risk factors.Aim. To assess the level of vitamin D in people older than 50 years with the presence/ absence of carotid artery atherosclerosis.Methods. The single-stage observational study was conducted, the study included 70 outpatients over 50 years of age, of which 17 (24%) were men and 53 (76%) were women. The mean age of the patients was 66 (60; 72) years. All examined patients underwent history taking, anthropometry, biochemical examination of blood plasma with the determination of lipid spectrum, glucose, creatinine and estimated glomerular filtration rate, echocardiographic examination. The presence of carotid atherosclerosis was determined by ultrasound examination of the carotid arteries. The study of the level of 25-OH vitamin D in blood serum was carried out by enzyme immunoassay (25-OH vitamin D ELISA).Results. It was found that about half (46%) of the  examined  persons  have  insufficient  levels of vitamin D in the blood plasma, while its deficiency (less than 20 ng/mL) was determined in 9% of patients. Individuals with carotid atherosclerosis had slightly lower levels of vitamin D than those without it, but the differences did not reach statistical significance. In acute coronary syndrome survivors, there was a statistically significant decrease in vitamin D levels, the vast majority of these patients had diabetes mellitus and abdominal obesity. Statistically significant moderate relationships were found between vitamin D levels and triglyceride levels (r = –0.33; p<0.05) and estimated glomerular filtration rate (r = 0.26; p<0.05), which confirms the association of vitamin D deficiency with metabolic syndrome. No statistical regularity was found between the level of vitamin D and other laboratory biochemical parameters, as well as morphological changes in the heart and blood vessels.Conclusion. Insufficient content of vitamin D in blood plasma is more common in individuals with a history of acute coronary syndrome, among them diabetes mellitus and abdominal obesity are more often detected, which confirms the relationship of vitamin D deficiency with metabolic syndrome.
50岁以上有或无颈动脉粥样硬化者维生素D缺乏症:一项横断面门诊研究
高光。在50岁以上有心血管危险因素的人群中,维生素D水平与肾小球滤过率和甘油三酯水平之间的关系得到了揭示。维生素D缺乏在急性冠脉综合征患者中更为常见。他们也更有可能患有腹部肥胖和2型糖尿病,这表明维生素D缺乏与代谢综合征之间存在关联。维生素D缺乏症和代谢综合征在人群中的高发需要进一步的大规模研究来确定维生素D水平和心血管危险因素之间的关系。评估50岁以上颈动脉粥样硬化存在/不存在人群的维生素D水平。采用单阶段观察性研究,纳入70例50岁以上门诊患者,其中男性17例(24%),女性53例(76%)。患者平均年龄66岁(60岁;72)年。所有患者均接受病史记录、人体测量、血浆生化检查(血脂谱、血糖、肌酐及肾小球滤过率测定)、超声心动图检查。颈动脉粥样硬化的存在是通过超声检查颈动脉来确定的。采用酶免疫分析法(25-OH维生素D ELISA)测定血清25-OH维生素D水平。研究发现,约有一半(46%)的被调查者血浆中维生素D含量不足,而9%的患者体内维生素D含量不足(低于20 ng/mL)。颈动脉粥样硬化患者的维生素D水平略低于没有颈动脉粥样硬化的人,但差异没有达到统计学意义。在急性冠状动脉综合征幸存者中,维生素D水平有统计学意义上的显著下降,这些患者绝大多数患有糖尿病和腹部肥胖。维生素D水平与甘油三酯水平之间存在统计学上显著的中度关系(r = -0.33;P <0.05)和估计肾小球滤过率(r = 0.26;p<0.05),证实维生素D缺乏与代谢综合征有关。维生素D水平与其他实验室生化指标及心脏和血管形态学变化之间无统计学规律性。血浆中维生素D含量不足在有急性冠状动脉综合征病史的个体中更为常见,其中糖尿病和腹部肥胖更为常见,这证实了维生素D缺乏与代谢综合征的关系。
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