目的:本研究探讨了血清25-羟维生素D3(25(OH)D3)水平与颈动脉内中膜厚度(CIMT)的关系,以及有吸烟史的个体存在颈动脉粥样硬化斑块。
方法:共469例怀疑有颈动脉粥样硬化的患者,年龄52至73岁,平均年龄65.26±4.37岁,于2023年1月至2023年10月从提交人的医院招募。所有患者均有近5年的吸烟史。根据他们的血清25(OH)D3水平,他们分为两组:正常组(血清水平30-50ng/mL,n=300)和缺乏组(<30ng/mL,n=169)。收集两组患者的一般细节。采用颈动脉超声评估脉搏波传导速度(PWV),颈动脉顺应性系数(CC),和CIMT。血液化学分析测定血清脂质代谢指标包括总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),和高密度脂蛋白胆固醇(HD-LC)。通过皮尔逊相关分析CIMT与各变量之间的关系,采用logistic回归分析确定影响颈动脉斑块发展的危险因素.
结果:两组患者一般资料差异无统计学意义(P>0.05)。与25(OH)D3正常组相比,25(OH)D3缺乏组患者的左右PWV和CC升高(P<0.05)。与正常组相比,缺乏组的MT和斑块面积更大(P<0.05)。此外,缺乏组表现出更高的TC水平,LDL-C,HD-LC与正常组比拟(P<0.05)。发现TC之间呈中度正相关,LDL-C,和CIMT(P<0.05),25(OH)D3与CIMT之间存在很强的正相关(P<0.05)。在吸烟者中,颈动脉斑块的形成与患者年龄等因素有关,CIMT,血清LDL-C,和25(OH)D3水平(P<0.05)。随着年龄的增长,CIMT,LDL-C水平升高,25(OH)D3水平下降,吸烟者颈动脉斑块风险增加(P<0.05)。
结论:25(OH)D3水平较低的吸烟者表现出较高的MTCI和更突出的颈动脉粥样硬化斑块,表明动脉僵硬度增加和心血管风险升高。这些发现证明了至关重要的意义,即维生素D水平不足可能导致吸烟者患动脉粥样硬化的风险更高。
OBJECTIVE: This study explores the association of serum 25-hydroxyvitamin D3 (25(OH)D3) levels with carotid artery intima-media thickness (CIMT), and the presence of carotid atherosclerotic plaques in individuals with a history of smoking.
METHODS: A total of 469 patients suspected of having carotid atherosclerosis, aged 52 to 73 years with an average age of 65.26 ± 4.37 years, were recruited from the author\'s hospital from January 2023 to October 2023. All patients had a smoking history of nearly 5 years. Based on their serum 25(OH)D3 levels, they were divided into two groups: the normal group (serum level 30-50 ng/mL, n = 300) and the deficiency group (<30 ng/mL, n = 169). General details of the two patient groups were collected. Carotid artery ultrasound was employed to assess pulse wave velocity (PWV), carotid artery compliance coefficient (CC), and CIMT. Blood chemistry analysis measured serum lipid metabolism indicators including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HD-LC). The relationship between CIMT and each variable was analyzed through Pearson correlation, and logistic regression was used to identify risk factors influencing carotid artery plaque development.
RESULTS: General patient information between the two groups showed no significant differences (P > 0.05). Patients in the 25(OH)D3 deficiency group exhibited elevated left and right PWV and CC compared to the 25(OH)D3 normal group (P < 0.05). The deficiency group exhibited larger CIMT and plaque area compared to the normal group (P < 0.05). Additionally, the deficiency group demonstrated higher levels of TC, LDL-C, and HD-LC compared to the normal group (P < 0.05). A moderate positive correlation was found between TC, LDL-C, and CIMT (P < 0.05), while a strong positive correlation existed between 25(OH)D3 and CIMT (P < 0.05). In smokers, the formation of carotid artery plaque was associated with factors such as patient age, CIMT, serum LDL-C, and 25(OH)D3 levels (P < 0.05). As age, CIMT, LDL-C levels increased, and 25(OH)D3 levels decreased, the risk of carotid plaques in smokers increased (P < 0.05).
CONCLUSIONS: Smokers with lower 25(OH)D3 levels exhibit higher CIMT and more prominent carotid atherosclerotic plaques, indicating increased arterial stiffness and elevated cardiovascular risk. These findings demonstrate crucial implications that insufficient levels of vitamin D may potentially contribute to a higher risk of atherosclerosis among smokers.