| BackgroundVitamin D(VD) is a kind of steroid hormone, Traditionally it is recognized actions on calcium and bone metabolism. Following the decades of research, it has been found that vitamin D has numerous potential biological effects. Recent studies have found that VD deficiency is more common in the population, the incidence of VD deficiency is increasing gradually, and there is a potential effect of vitamin D on the pathophysiology of cardiovascular diseases, and vitamin D deficiency may be related to variety of cardiovascular diseases and risk factors. It is involved in cardiac remodeling and affected left ventricular diastolic function may be related to the regulation of inflammatory factors metabolism, myocardial cell calcium influx, renin-angiotensin-aldosterone system(RAAS) activity and the balance of collagen metabolism deposition.ObjectiveTo observe concentration status of serum 25-hydroxyvitamin D(25-OHD) in hypertensives; To discuss the relationship between 25-OHD, inflammatory factors and the left ventricular diastolic function.Methods165 hypertensive patients were collected continuously from 2013 September to 2013 December in cardiovascular department of the Second Affiliated Hospital of Nanchang University. We recorded their characteristics such as age, sex, height and weight through the detailed history. We also measured blood pressure precisely, extracted venous blood with fasting state at 7 a.m. in order to test blood biochemical indices such as high-sensitive C-reactive protein(Hs-CRP) and blood glucose. Additionally, we measured serum 25-OHD level by enzyme linked immunosorbent assay(ELISA). We also performed conventional echocardiographic data such as left ventricular ejection fraction, left atrium dimension and diastolic function indexes including peak velocities of early(E) and late(A), diastolic mitral annular velocitiesof early(e’) and late(a’).According to Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography 2009 and ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012, subjects were divided into hypertensives with normal left ventricular diastolic function(n=62) and hypertensives with left ventricle diastolic dysfunction(LVDD)(n=103).Then, the comparisons concerning common data, echocardiographic data, serum 25-OHD level between two groups and their correlation were performed.ResultsIn all 198 subjects, the mean serum 25-OHD concentration was 21.65±9.25nmol/L, the serum 25-OHD more than 30 ng/m L in 15.76%, and lower than 30 ng/m L in 37.58%,lower than 20 ng/m L in 37.58%, lower than 10 ng/m L in 9.08%.Compared with hypertensives with normal left ventricular diastolic function, the subjects of other group had lower serum 25-OHD[(19.56±8.74)mm vs.(25.12±9.09)mm, P<0.01] and mean e’ [(8.82±2.54) vs.(6.79±1.30), P<0.01], more incidence of VD insufficient(66.9% vs. 33.1%,P<0.01), VD deficiency(75.3% vs. 24.7%,P<0.01), Hs-CRP[(1.93±1.91) mg/L vs.(1.06±1.00) mg/L, P<0.01], left atrium dimension[(32.90±3.94)mm vs.(30.69±2.74) mm, P<0.01], left ventricular mass(LVM) [(161.75±40.74) g vs.(141.31±28.64) g, P<0.01], E/mean e’ [(8.82±2.54) vs.(6.79±1.30), P<0.01]. Pearson correlation analysis displayed that 25-OHD was related to mean e’(r= 0.253, P<0.01),Hs-CRP(r=-0.170, P<0.05), left atrium dimension(r=-0.242, P<0.01), E/mean e’(r=-0.158, P<0.05).Multiple linear stepwise regression analysis indicated that 25-OHD was the independent influence factor of left atrium dimension(t=-2.603, P<0.01)and mean e’(t=2.353,P<0.05),Hs-CRP was the independent influence factor of left atrium dimension(t=2.428,P<0.05), LVM(t=1.984,P<0.05)and mean e’(t=-2.568,P<0.05).Binary logistic regression analysis revealed that Age(OR=1.081,P<0.01), 25-OHD(OR=0.953,P<0.05), Hs-CRP(OR=1.619,P<0.01)were associated with left ventricle diastolic.ConclusionCompared with hypertensives with normal left ventricular diastolic function, serum 25-OHD levels were lower in subjects with LVDD. Vitamin D insufficient and deficiency were highly prevalent in LVDD group. Serum 25-OHD was positivecorrelation with e’, negative correlation with Hs-CRP, left atrium dimension, E/mean e’. 25-OHD might be involved in cardiac remodeling and affected left ventricular diastolic function related to the regulation of inflammatory factors metabolism. |
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