Журнал «Боль. Суставы. Позвоночник» 1 (21) 2016
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Vitamin D status in patients with cardiovascular disease according to age, gender and diagnosis
Авторы: Yankovskaya L., SnezhitskiyV. - Grodno State Medical University; Moyseenok A. - National Enterprise «Institute of Biochemistry of biologically active compounds of the NAS of Belarus», Grodno, Belarus
Рубрики: Ревматология, Травматология и ортопедия
Разделы: Медицинские форумы
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The article was published on p. 86-87
Aim of the research — to assess the difference of 25-hydroxy-cholecalciferol (25(OH)D) level in blood plasma in patients with arterial hypertension (AH) and coronary heart disease (CHD) according to age, sex and diagnosis.
Materials and methods. We examined 539 individuals (152 men and 387 women) aged 30 to 79 years. Among them 71 participants did not have any cardiovascular disease, 221 had II degree of AH, 247 suffered from CHD. Vitamin D status was assessed by the serum level of vitamin D total (25(OH)D total = 25(ОН)D3 + 25(ОН)D2) using immunoenzymatic assay with the help of original DRG reagents. Level of parathyroid hormone (PTH) in blood plasma was estimated by means of the same method. Statistical analysis was carried out by «STATISTICA 10.0» software.
Results. We found an negative correlation between age and level of 25(OH)D in blood plasma in a whole group (R = –0.21; p = 0.000001) and in joint group with AH and CHD (R = 0.198; p = 0.000015, n = 468), but after dividing patients into three groups by diagnosis this correlation appeared to be not significant in each group. To assess the effect of age, sex and diagnosis on the level of 25(OH)D, we performed multiple linear regression analysis by forward stepwise method. Formed regressional relationship was significant (R2 = 0.10; F (2.42) = 19.77; p < 0.000001), b coefficient for the independent variables included in the model was significant for age and PTH and valued at –0.18 (p = 0.001) and –0.097 (p = 0.000001) respectively, which indicates their negative association with the level of 25(OH)D. Also another regression equation was significant (R2 = 0,07; F (6,44) = 5,58; p < 0,00001), b coefficient for the independent variables included in the model was significant for sex and diagnosis and valued at –0.10 (p = 0.027) and –0.18 (p = 0.003), which also indicates their negative correlation with the level of 25(OH)D.
After separation of the entire group by the age into 5 subgroups: 3b — 30–39; 4b — 40–49; 5b — 50–59; 6b — 60–69; 7b — 70–79 years we found the differences (p = 0.00002) in the level of 25(OH)D between the group 3b, where the level was highest (25.3 ± 11.3 ng/ml) and other four groups, between 7b group where the level of 25(OH)D was the lowest (14.97 ± 9.20 ng/ml) and group 3b (p = 0.000004), 4b (p = 0.007), 5b (p = 0.006). However, after separation of groups by diagnosis in each of them there were no differences by level of 25(OH)D between age groups. After separation into groups by diagnosis ANOVA analysis revealed that CHD group was older (64.6 ± 8.1 years) than control group (46.1 ± 6.7 years; p = 0.00001) and the AH group (52.4 ± 7.6 years; p = 0.000009). Levels of 25(OH)D in blood plasma in CHD group was 13.2 (8.3; 21.1) ng/ml and was lower (p = 0.00001) than in AH group — 20.1 (12.4; 29.1) ng/ml and lower (p = 0.00001) than in the control group — 20.8 (11.4; 27.9) ng/ml. Furthermore, PTH level in CHD group was the highest — 46.16 (33.19; 71.57) pg/ml and was higher (p = 0.0001) than in AH group — 36.67 (25.22; 51.29) pg ml and control group (43.12 (28.54, 55.26) pg/ml; p = 0.002). After separation of groups by sex no significant differences in 25(OH)D levels were found in a whole group and in groups separated by diagnosis, as well as in comparison of 5 subgroups comparable by age.
Conclusions. 25(OH)D level in blood plasma is negatively associated with age and it is dependent on cardiovascular diseases, in particular it is lower in individuals with CHD compared to individuals with AH II degree. Gender does not have a significant effect on the level of 25(OH)D in the blood plasma.