河南农村人群维生素D水平与高血压患病风险的关联

王腾; 孙华磊; 葛惠娜; 刘欣欣; 韩涵; 王俊; 李星; 李文杰

doi:10.16462/j.cnki.zhjbkz.2019.07.008

河南农村人群维生素D水平与高血压患病风险的关联

doi: 10.16462/j.cnki.zhjbkz.2019.07.008

450001 郑州, 郑州大学公共卫生学院营养与食品卫生教研室

基金项目:

国家自然科学基金 81573151

详细信息

通讯作者:
李文杰, E-mail: lwj@zzu.edu.cn

中图分类号: R346.5;R544.1
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出版历程
- 收稿日期: 2019-01-28
- 修回日期: 2019-04-18
- 刊出日期: 2019-07-10

Association of vitamin D and risk of hypertension in Henan rural population

Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, China

Funds:

National Natural Science Foundation of China 81573151

More Information

Corresponding author: LI Wen-jie, E-mail: lwj@zzu.edu.cn

摘要

摘要: 目的调查河南农村居民的维生素D(vitamin D，VD)缺乏以及高血压流行现状，探讨VD水平与高血压患病风险之间的关联。方法整群抽样方法选取18~80岁河南农村居民为研究对象，采用Logistic回归计算VD与高血压患病风险之间的OR值和95%CI，并使用限制性立方样条模型拟合VD与高血压患病风险之间的剂量-反应关系。结果共纳入研究对象2 013人，血清25-羟基维生素D(25-hydroxy-vitamin D，25-(OH)D)平均水平为(24.50±16.18)ng/ml，其中VD缺乏者占53.95%，不足者占27.02%，只有19.03%能达到正常水平；高血压患病率为40.34%(年龄标化率30.64%)。高血压患者VD水平低于非高血压人群，且VD缺乏人群的高血压患病率(45.21%)高于VD充足人群(31.07%)；相比VD充足人群，VD缺乏人群的高血压患病风险升高(OR=1.59，95%CI：1.21~2.10)，血清VD水平每升高10 ng/ml，高血压患病风险下降14%，限制性立方样条模型显示VD水平与高血压患病风险存在"L"型剂量-反应关系。结论 VD缺乏与高血压患病风险升高有关，VD水平与高血压患病风险存在"L"型剂量-反应关系。
- 维生素D /
- 高血压 /
- 农村人群
Abstract: Objective The purpose of this study was to investigate the prevalence of vitamin D deficiency and hypertension in Henan rural residents, and to explore the association between vitamin D and risk of hypertension. Methods 2 013 Henan rural participants aged 18-80 years were recruited from a cross-sectional study. Logistic regression models and restricted cubic spline model were used to evaluate odds ratios (OR), 95% confidence intervals (95% CI) and dose-response relationship between vitamin D and risk of hypertension. Results In total population, the prevalence of hypertension was 40.34% (30.64% after age-standard), and the mean serum 25-(OH)D was (24.50 ±16.18) ng/ml, and 53.95% of all participants were presenting vitamin D deficiency. Compared with non-hypertension, a lower level of serum 25-(OH)D was observed in people with hypertension. The prevalence of hypertension was 45.21% in vitamin D deficient group which was higher than in the vitamin D sufficient group (31.07%). Compared with the vitamin D sufficient group, the risk of hypertension was increase in the vitamin D deficient group (OR=1.59, 95% CI: 1.21-2.10), and the risk of hypertension decreased by 14% for every 10 ng/ml increase in serum 25-(OH) D levels. Moreover, an L-shaped relationship was observed between 25-(OH)D concentration and risk of hypertension. Conclusion Vitamin D deficiency is associated with risk of hypertension and there is an L-shaped relationship between 25-(OH)D concentration and risk of hypertension.
- Vitamin D /
- Hypertension /
- Rural population

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图 1 血清25-(OH)D浓度与高血压患病风险的限制性立方样条模型分析

注：实线表示高血压OR值，虚线表示95% CI值。调整混杂因素：性别(1=男，2=女)、年龄(1=＜40岁，2=40~岁，3=≥60岁)、吸烟(1=不吸，2=已戒烟，3=吸烟)、饮酒(0=否，1=是)、体力活动(1=轻度，2=中度，3=重度)、高脂饮食(0=否，1=是)、BMI(0=＜18.5 kg/m²，1=18.5~ kg/m²，2=24.0~ kg/m²，3=≥28 kg/m²)。

Figure 1. Restricted cubic spline model analysis between the association of 25-(OH)D and hypertension risk

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表 1 研究对象行为危险因素及VD水平分布特征[n(%)]

Table 1. Characteristics of lifeway and vitamin D level in participants[n(%)]

变量	n(%)	25-(OH) D (ng/ml)	F/t值	P值	VD缺乏[n(%)]	χ²值	P值
吸烟情况			1.70	0.184		4.35	0.114
不吸烟	1 394(69.25)	24.12±16.18			772(55.38)
戒烟	165(8.20)	24.28±15.75			88(55.33)
吸烟	454(22.55)	25.72±16.31			226(49.78)
饮酒			9.18	0.002		2.54	0.111
否	1 656(82.27)	26.50±17.73			907(54.77)
是	357(17.73)	24.06±15.80			179(50.14)
体力活动			0.05	0.950		1.55	0.461
轻度	791(39.29)	24.64±16.67			423(53.48)
中度	404(20.07)	24.35±16.08			229(56.68)
重度	818(40.64)	24.43±15.77			434(53.06)
高脂饮食			3.10	0.078		0.91	0.341
否	1 591(79.04)	24.61±16.45			867(54.49)
是	422(20.96)	24.06±15.12			219(51.90)
咸菜			36.71	< 0.001		1.06	0.304
少量/不吃	1 684(83.66)	24.87±16.81			917(54.45)
较多	329(16.34)	22.59±12.33			169(51.73)

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表 2 研究对象高血压患病现况[n(%)]

Table 2. The prevalence of hypertension in participants[n(%)]

变量	非高血压(n=1 201)	高血压(n=812)	χ²/Z值	P值
性别			0.69	0.407
男	555(60.66)	360(39.34)
女	646(58.83)	452(41.17)
年龄(岁)			253.24	＜0.001
＜40	359(87.99)	49(12.01)
40~	520(63.34)	301(36.66)
≥60	322(41.07)	462(58.93)
职业			32.24	＜0.001
务工	154(69.68)	67(30.32)
务农	884(56.38)	684(42.62)
办公人员	163(72.77)	61(27.23)
吸烟情况			28.66	＜0.001
不吸烟	882(63.27)	512(36.73)
戒烟	96(58.18)	69(41.82)
吸烟	223(49.12)	231(50.88)
饮酒			0.51	0.476
否	994(60.02)	662(39.98)
是	207(57.98)	150(42.02)
文化程度			85.37	＜0.001
小学及以下	434(48.44)	462(51.56)
初中	569(69.47)	250(30.53)
高中及以上	198(66.44)	100(33.56)
体力活动			34.29	＜0.001
轻度	410(51.83)	381(48.17)
中度	253(62.62)	151(37.38)
重度	538(65.77)	280(34.23)
高脂饮食			15.94	＜0.001
否	985(61.91)	606(38.09)
是	216(51.18)	206(48.82)
收缩压(mmHg)	116.08±12.06	142.51±16.81	74.41	＜0.001
舒张压(mmHg)	74.68±8.12	86.93±10.20	40.16	＜0.001
咸菜			0.80	0.370
少量/不吃	1 012(60.10)	672(39.90)
较多	189(57.45)	140(42.55)
BMI(kg/m²)	24.18±3.80	26.22±3.69	0.83	0.362
WHR	0.89±0.07	0.92±0.07	5.46	0.020
FBG(mmol/L)	5.23±2.16	5.90±2.34	23.27	＜0.001
TC(mmol/L)	4.36±0.98	4.66±0.98	0.02	0.890
TG(mmol/L)	1.54±1.26	1.96±1.47	20.06	＜0.001
HDL-C(mmol/L)	1.24±0.30	1.23±0.30	0.01	0.924
LDL-C(mmol/L)	2.45±0.78	2.61±0.78	0.01	0.981
Ins(IU/ml)	13.71±8.00	11.89±6.41	16.48	＜0.001
25-(OH)D(ng/ml)	26.13±17.53	22.09±13.60	31.41	＜0.001

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表 3 血清25-(OH)D水平与高血压患病风险的Logistic回归

Table 3. Logistic regression analysis of 25-(OH)D levels and risk of hypertension

血清25-(OH)D水平(ng/mL)	调整模型
血清25-(OH)D水平(ng/mL)	未调整OR(95% CI)值	模型一OR(95% CI)值	模型二OR(95% CI)值
充足(≥30)	1.00	1.00	1.00
不足(20~)	1.41(1.01~1.73)	1.25(0.80~1.45)	1.15(0.84~1.57)
缺乏(＜20)	1.84(1.45~2.35)	1.60(1.25~2.20)	1.59(1.21~2.10)
每10 ng/ml	0.84(0.79~0.89)	0.86(0.82~0.93)	0.86(0.80~0.93)
注：模型一：调整性别(1=男，2=女)、年龄(1=＜40岁，2=40~岁，3=≥60岁)；模型二：调整性别(1=男，2=女)、年龄(1=＜40，2=40~，3=≥60)、吸烟(1=不吸，2=已戒烟，3=吸烟)、饮酒(0=否，1=是)、体力活动(1=轻度，2=中度，3=重度)、高脂饮食(0=否，1=是)和BMI(0=＜18.5 kg/m²，1=18.5~ kg/m²，2=24.0~ kg/m²，3=≥28 kg/m²)。

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