维生素d与心血管疾病关系研究进展 - 中华老年多器官疾病杂志.docVIP

·综 述· 维生素D与心血管疾病关系研究进展 谷伟军，潘长玉* （解放军总医院内分泌科, 北京 100853） 【摘 要】维生素D不仅对人体钙磷代谢和骨质钙化有重要作用，而且对全身各组织细胞都有广泛作用，与各种重要疾病均有密切关系。其中，维生素D缺乏与心血管疾病关系日益受到国际医学界的重视。其可能通过增加甲状旁腺激素、激活肾素-血管紧张素-醛固酮系统、增加胰岛素抵抗等机制对心血管系统产生不良影响，引起高血压、左室肥厚、代谢综合征、系统炎症，从而增加动脉粥样硬化和心血管事件。目前，在我国大多数医院都没有维生素D的检验项目，且缺乏有关维生素D水平的流行病学资料，许多医务和科研人员对其认识仅还停留在对钙磷代谢的影响。本文就维生素D缺乏与心血管疾病的关系以及补充维生素D降低心血管事件等方面临床研究作一系统回顾，以期提高我国学者对维生素D重视，加强相关研究。 【关键词】维生素D; 维生素D受体; 心血管疾病 【中图分类号】 R591.44 【文献标识码】 A 【DOI】 10.3724/SP.J.1264.2012.00020 Clinical advances in relationship of vitamin D and cardiovascular diseases GU Weijun, PAN Changyu* (Department of Endocrinology, PLA General Hospital, Beijing 100853, China) 【Abstract】 Traditionally, vitamin D is regarded as an important hormone which is involved in the metabolism of calcium and phosphate, and mineralization of bone. A growing number of evidences indicate that vitamin D receptors are present on a large variety of cell types, and vitamin D is associated with many diseases closely, among which the relationship between Vitamin D deficiency and cardiovascular (CV) diseases has gained increasingly more attention. Vitamin D deficiency may adversely affect the CV system, including increasing levels of parathyroid hormone, activating the renin-angiotensin-aldosterone system, and increasing insulin resistance, thus lead to hypertension, left ventricular hypertrophy, metabolic syndrome, and general inflammation, then eventually cause atherosclerosis and CV events. This article is a review of the clinical evidences that vitamin D deficiency is associated with incidence of CV events, as well as evidences that vitamin D supplementation is associated with reduction in CV diseases. 【Key words】 vitamin D; vitamin D receptor; cardiovascular disease 维生素D缺乏在美国及全球都较为常见，大约占总人口数的30%～50%。据美国医学研究所（The Institute of Medicine，IOM）报告，全美大约有1/4人群维生素D缺乏，8%高危，只有1%维生素D含量过高存有潜在危险。维生素D 是机体内维持钙磷平衡的重要有机物质。维生素D缺乏最常表现为骨骼肌肉系统的受累，儿童表现为佝偻病，成人表现为骨质疏松、骨软化。维生素D 受体（vitamin D receptor，VDR）广泛表达于人体的各种细胞，如成骨细胞、免疫细胞、神经细胞、胰岛