國(guó)際心血管領(lǐng)域高水平期刊Circulation Research于近日在線發(fā)表我校公共衛(wèi)生學(xué)院營(yíng)養(yǎng)學(xué)系論文“Serum Bioavailable and Free 25-Hydroxyvitamin D Levels, but Not Its Total Level, Are Associated With the Risk of Mortality in Patients With Coronary Artery Disease. Circulation Research. 2018;123:996–1007 ”，該文通訊作者為我校公共衛(wèi)生學(xué)院凌文華教授，第1作者為其博士研究生余超、薛宏亮。該文引起主編的關(guān)注，并獲得Circulation Research題為“Have We Been Measuring the Wrong Form of Vitamin D? Vitamin D as a Prognostic Biomarker for Coronary Artery Disease Mortality”的同刊評(píng)述。
Kaplan-Meier plots for all-cause mortality (A) and cardiovascular mortality (B) according to bioavailable 25-hydroxyvitamin D [25(OH)D] quartiles, and all-cause mortality (C) and cardiovascular mortality (D) according to free 25(OH)D quartiles among patients with coronary artery disease.
Multivariable-adjusted spline functions demonstrate the relation between bioavailable 25-hydroxyvitamin D and all-cause mortality (A) and cardiovascular mortality (B), and the relation between free 25-hydroxyvitamin D and all-cause mortality (C) and cardiovascular mortality (D). The histogram of the distribution of bioavailable or free 25-hydroxyvitamin D levels is also shown. Deaths were shown in dark brown column, and survivals were shown in light brown column.
維生素D是一種脂溶性維生素，也是一種固醇類激素前體，與健康密切相關(guān)。目前，全球大多數(shù)研究均以循環(huán)25-OH-D評(píng)價(jià)人體維生素D狀態(tài)，以及其與慢病的關(guān)聯(lián)，但結(jié)果并不一致。近來(lái)，多項(xiàng)隨機(jī)對(duì)照研究（RCT）也發(fā)現(xiàn)，并非所有“維生素D缺乏”患者都可以從維生素D補(bǔ)充中獲益，提示傳統(tǒng)標(biāo)志物并不能評(píng)價(jià)維生素D的生物可利用狀態(tài)。凌文華教授團(tuán)隊(duì)通過(guò)對(duì)其課題組已建立的“廣東冠心病隊(duì)列”患者基線血清的多項(xiàng)維生素D標(biāo)志物檢測(cè)，經(jīng)中位6.7年隨訪后發(fā)現(xiàn)，生物可利用維生素D（BioD）及游離維生素D（Free D）水平，而不是傳統(tǒng)標(biāo)志物25-OH-D，可獨(dú)立預(yù)測(cè)冠心病患者的死亡風(fēng)險(xiǎn)。研究提示血清 BioD和FreeD水平對(duì)冠心病風(fēng)險(xiǎn)評(píng)估更有價(jià)值，25-OH-D是否為合適的反映維生素D狀態(tài)的標(biāo)志物值得進(jìn)一步研究。研究為選擇正確的血清維生素D標(biāo)志物來(lái)預(yù)測(cè)冠心病患者的預(yù)后提供了重要的科學(xué)依據(jù)。
論文鏈接：https://www.ahajournals.org/doi/pdf/10.1161/CIRCRESAHA.118.313558
同刊評(píng)述鏈接：https://www.ahajournals.org/doi/pdf/10.1161/CIRCRESAHA.118.313814
