Vitamin D measurement and effect on outcome in a cohort of patients with heart failure

Saponaro, Federica; Frascarelli, Sabina; Frontera, Concetta; Clerico, Aldo; Scalese, Marco; Sessa, Maria Rita; Cetani, Filomena; Borsari, Simona; Pardi, Elena; Marvelli, Antonella; Marcocci, Claudio; Passino, Claudio; Zucchi, Riccardo

doi:10.1530/ec-18-0207

Cited by 16 publications

(9 citation statements)

References 35 publications

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“…In our study, the mean serum values of 25-OH-D 3 were significantly lower in heart failure patients compared to CON (20.49 ± 7.31 vs. 37.09 ± 4.59 ng/mL, p < 0.001), as confirmed in previous studies [23,24]. Multiple regression analysis by the Enter method considering 25-OH D3 as dependent variable demonstrated indicators of vascular stiffness RRI ( p = 0.004) and c-f PWV ( p = 0.005) as predictors, suggesting that vitamin D deficit might contribute to increased vascular stiffness in heart failure (Table 2).…”

Section: Discussionsupporting

confidence: 91%

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

et al. 2019

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Background and objectives: The purpose of the study is to correlate vascular calcification biomarkers osteoprotegerin (OPG) and 25-hydroxyvitamin D3 (25-OH-D3), indicators of arterial stiffness carotid-femoral pulse wave velocity (c-f PWV) and renal resistive index (RRI), with parameters of left ventricular function in heart failure patients versus control. Materials and methods: Our case-control study compared 60 patients with ischemic heart failure and reduced left ventricular ejection fraction (LVEF) (<40%) with a control group of 60 healthy age-matched subjects (CON). Serum levels of OPG and 25-OH-D3 were determined by ELISA. Left ventricular volumes (LVESV, LVEDV) and LVEF were measured by echocardiography. C-f PWV was determined using the arteriograph device. RRI was measured by duplex Doppler. Peak systolic velocity (PSV) and minimum end-diastolic velocity (EDV) were determined using angle correction. The estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation. The Pearson’s correlation coefficient was used for interpretation of results. Results: OPG values were significantly higher in heart failure (HF) patients vs. CON (4.7 ± 0.25 vs. 1.3 ± 0.67 ng/mL, p < 0.001). 25-OH vitamin D3 levels were significantly lower in HF patients vs. CON (20.49 ± 7.31 vs. 37.09 ± 4.59 ng/mL, p < 0.001). Multiple regression analysis considering 25-OH D3 as a dependent variable demonstrated indicators of vascular stiffness RRI, c-f PWV and vascular calcification biomarker OPG as predictors. OPG values were significantly correlated with cardiac parameters LVEDV (r = 0.862, p < 0.001), LVEF (r = −0.832, p < 0.001), and c-f PWV(r = 0.833, p < 0.001), and also with 25-OH-D3 (r = −0.636, p < 0.001). RRI values were significantly correlated with cardiac parameters LVEDV (r = 0.586, p < 0.001) and LVEF (r = −0.587, p < 0.001), and with eGFR (r = −0.488, p < 0.001), c-f PWV(r = 0.640, p < 0.001), and 25-OH-D3 (r = −0.732, p < 0.001). Conclusions: This study showed significant correlations between vitamin D deficit and vascular stiffness indicators in heart failure patients with reduced ejection fraction, demonstrating the importance of these examinations for a better evaluation of these patients. Together with the evaluation of renal function, the measurement of vascular stiffness indicators and biomarkers might play a key role in identifying patients at greater risk for worsening disease prognosis and for shorter life expectancy, who could benefit from vitamin D supplementation. The abstract was accepted for presentation at the Congress of the European Society of Cardiology, Munich, 2018.

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Section: Discussionsupporting

confidence: 91%

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

et al. 2019

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“…Our group recently reported results from an Italian cohort of 261 patients with HF in whom low serum levels of 25OHD were inversely correlated with a validated score of HF mortality, namely the Metabolic Exercise Cardiac Kidney Index or MECKI score [126]. In a subgroup of these patients, cardiovascular outcomes have been also reported: patients with HF had mean serum levels of 25OHD statistically lower than healthy subjects (45.2 ± 23.7 nmol/L vs. 58.2 ± 24.0 nmol/L, p < 0.001) and a higher prevalence of vitamin D insufficiency (serum 25OHD < 50 nmol/L or 20 ng/mL) (61.1% vs. 39.5%, p < 0.001), associated with higher mortality risk [127].…”

Section: Pleiotropic Effects Of Vitamin Dmentioning

confidence: 92%

An Update on Vitamin D Metabolism

Saponaro

Saba

Zucchi

2020

IJMS

Self Cite

205

150

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Vitamin D is a steroid hormone classically involved in the calcium metabolism and bone homeostasis. Recently, new and interesting aspects of vitamin D metabolism has been elucidated, namely the special role of the skin, the metabolic control of liver hydroxylase CYP2R1, the specificity of 1α-hydroxylase in different tissues and cell types and the genomic, non-genomic and epigenomic effects of vitamin D receptor, which will be addressed in the present review. Moreover, in the last decades, several extraskeletal effects which can be attributed to vitamin D have been shown. These beneficial effects will be here summarized, focusing on the immune system and cardiovascular system.

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“…Most of the risk factors for HFrEF in Western populations have been described in association with ischemic heart disease [15]. It has been proposed that vitamin D might play a role in disease pathogenesis, as serum 25(OH)D levels have been demonstrated to be lower in patients with HF compared with control subjects [16]. Specifically, prospective studies have shown that the risk of developing HF is increased in patients with vitamin D deficiency [17].…”

Section: Introductionmentioning

confidence: 99%

Correlation of Vitamin D with Inflammatory Cytokines, Atherosclerotic Parameters, and Lifestyle Factors in the Setting of Heart Failure: A 12-Month Follow-Up Study

Roffe-Vazquez

Delgado

Castillo

et al. 2019

IJMS

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Vitamin D deficiency is highly prevalent worldwide. It has been associated with heart failure (HF) given its immunoregulatory functions. In-vitro and animal models have shown protective roles through mechanisms involving procollagen-1, JNK2, calcineurin/NFAT, NF-κB, MAPK, Th1, Th2, Th17, cytokines, cholesterol-efflux, oxLDL, and GLUT4, among others. A 12-month follow-up in HF patients showed a high prevalence of vitamin D deficiency, with no seasonal variation (64.7–82.4%). A positive correlation between serum 25(OH)D concentration and dietary intake of vitamin D-rich foods was found. A significant inverse correlation with IL-1β (R = −0.78), TNF-α (R = −0.53), IL-6 (R = −0.42), IL-8 (R = −0.41), IL-17A (R = −0.31), LDL-cholesterol (R = −0.51), Apo-B (R = −0.57), total-cholesterol (R = –0.48), and triglycerides (R = −0.32) was shown. Cluster analysis demonstrated that patients from cluster three, with the lowest 25(OH)D levels, presented the lowermost vitamin D intake, IL-10 (1.0 ± 0.9 pg/mL), and IL-12p70 (0.5 ± 0.4 pg/mL), but the highest TNF-α (9.1 ± 3.5 pg/mL), IL-8 (55.6 ± 117.1 pg/mL), IL-17A (3.5 ± 2.0 pg/mL), total-cholesterol (193.9 ± 61.4 mg/dL), LDL-cholesterol (127.7 ± 58.2 mg/dL), and Apo-B (101.4 ± 33.4 mg/dL) levels, compared with patients from cluster one. Although the role of vitamin D in the pathogenesis of HF in humans is still uncertain, we applied the molecular mechanisms of in-vitro and animal models to explain our findings. Vitamin D deficiency might contribute to inflammation, remodeling, fibrosis, and atherosclerosis in patients with HF.

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Vitamin D measurement and effect on outcome in a cohort of patients with heart failure

Cited by 16 publications

References 35 publications

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients

An Update on Vitamin D Metabolism

Correlation of Vitamin D with Inflammatory Cytokines, Atherosclerotic Parameters, and Lifestyle Factors in the Setting of Heart Failure: A 12-Month Follow-Up Study

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