目的:已知维生素D会影响心血管疾病的风险,这是公认的心脏骤停(SCA)的危险因素。然而,维生素D和SCA之间的关系尚不清楚。因此,本研究旨在调查院外心脏骤停(OHCA)患者与健康对照组中维生素D和SCA之间的相关性.
结果:使用具有独特注册和流行病学监测(CAPTURESII)注册表的II期心脏骤停追踪试验,一项1:1倾向评分匹配的病例对照研究于2017年至2020年进行.OHCA患者(454例)和健康对照(454例)的血清25-羟维生素D(维生素D)水平进行年龄匹配后比较,性别,心血管危险因素,和生活方式行为。SCA病例和对照组的平均维生素D水平分别为14.5±7.6和21.3±8.3ng/mL,分别。Logistic回归分析用于调整心血管危险因素,生活方式行为,校正血清钙水平,和估计的肾小球滤过率(eGRF)。维生素D的校正比值比(aOR)为0.89(95%置信区间[CI]0.87-0.91)。剂量-反应关系表明维生素D缺乏与SCA发病率相关(严重缺乏,OR10.87,95%CI4.82-24.54;中度缺乏,OR2.24,95%CI1.20-4.20)。
结论:维生素D缺乏与SCA风险增加独立且强烈相关,不考虑心血管和生活方式因素,校正钙水平,和eGFR。
OBJECTIVE: Vitamin D is known to influence the risk of cardiovascular disease, which is a recognized risk factor for sudden cardiac arrest (SCA). However, the relationship between vitamin D and SCA is not well understood. Therefore, this study aims to investigate the association between vitamin D and SCA in out-of-hospital cardiac arrest (OHCA) patients compared to healthy controls.
RESULTS: Using the Phase II Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES II) registry, a 1:1 propensity score-matched
case-control study was conducted between 2017 and 2020. Serum 25-hydroxyvitamin D (vitamin D) levels in patients with OHCA (454 cases) and healthy controls (454 cases) were compared after matching for age, sex, cardiovascular risk factors, and lifestyle behaviors. The mean vitamin D levels were 14.5 ± 7.6 and 21.3 ± 8.3 ng/mL among SCA cases and controls, respectively. Logistic regression analysis was used adjusting for cardiovascular risk factors, lifestyle behaviors, corrected serum calcium levels, and estimated glomerular filtration rate (eGRF). The adjusted odds ratio (aOR) for vitamin D was 0.89 (95% confidence interval [CI] 0.87-0.91). The dose-response relationship demonstrated that vitamin D deficiency was associated with SCA incidence (severe deficiency, aOR 10.87, 95% CI 4.82-24.54; moderate deficiency, aOR 2.24, 95% CI 1.20-4.20).
CONCLUSIONS: Vitamin D deficiency was independently and strongly associated with an increased risk of SCA, irrespective of cardiovascular and lifestyle factors, corrected calcium levels, and eGFR.