1
|
Chen X, Xu J, Wan Z, Geng T, Zhu K, Li R, Lu Q, Lin X, Liu S, Ou Y, Yang K, An P, Manson JE, Liu G. Vitamin D and heart failure risk among individuals with type 2 diabetes: observational and Mendelian randomization studies. Am J Clin Nutr 2024; 120:491-498. [PMID: 39053885 DOI: 10.1016/j.ajcnut.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Evidence is limited and inconsistent regarding vitamin D and heart failure (HF) risk in people with type 2 diabetes (T2D), among whom vitamin D insufficiency or deficiency is common. OBJECTIVES This study aimed to investigate the associations of serum 25-hydroxyvitamin D [25(OH)D] with HF risk among individuals with T2D, in observational and Mendelian randomization (MR) frameworks. METHODS Observational analyses were performed among 15,226 T2D participants aged 40-72 y from the UK Biobank. HF incidence was ascertained through electronic health records. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between serum 25(OH)D and HF risk among people with T2D. MR analyses were conducted among 11,260 unrelated participants with T2D. A weighted genetic risk score for genetically predicted 25(OH)D concentration was instrumented using 62 confirmed genome-wide variants. RESULTS The mean ± standard deviation of serum 25(OH)D was 43.4 ± 20.4 nmol/L. During a median follow-up of 11.3 y, 836 incident HF events occurred. Serum 25(OH)D was nonlinearly and inversely associated with HF and the decreasing risk tended to plateau at around 50 nmol/L. Comparing those with 25(OH)D <25 nmol/L, the multivariable-adjusted HR (95% CI) was 0.67 (0.54, 0.83) for participants with 25(OH)D of 50.0-74.9 nmol/L and was 0.71 (0.52, 0.98) for 25(OH)D >75 nmol/L. In MR analysis, each 7% increment in genetically predicted 25(OH)D was associated with 36% lower risk of HF among people with T2D (HR: 0.64, 95% CI: 0.41, 0.99). CONCLUSIONS Higher serum 25(OH)D was associated with lower HF risk among individuals with T2D and the MR analysis suggested a potential causal relationship. These findings indicate a role of maintaining adequate vitamin D status in the prevention of HF among individuals with T2D.
Collapse
Affiliation(s)
- Xue Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajing Xu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Lin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sen Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunjing Ou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Yang
- Department of Endocrinology, Guoyao Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Pan An
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
2
|
Gerede Uludag DM, Aydogan BI, Tan TS, Acıbuca A, Turan N, Emral R, Dincer I, Erol C. Evaluation of the Relationship Between Vitamin D Deficiency and Subclinical Cardiac Dysfunction Using 2D/3D Strain Echocardiography in Healthy People. KARDIOLOGIIA 2024; 64:73-79. [PMID: 38462807 DOI: 10.18087/cardio.2024.2.n2331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/16/2023] [Indexed: 03/12/2024]
Abstract
AIM Vitamin D deficiency has a high prevalence in the population and is highly associated with cardiovascular diseases. The aim of this study was to evaluate subclinical left ventricular (LV) function using strain analysis in healthy individuals with vitamin D deficiency. MATERIAL AND METHODS 113 healthy volunteers were enrolled in the study (age, 44.1±7 yrs, 34 male). All volunteers underwent two-dimensional (2D) and three-dimensional (3D) speckle tracking echocardiography after conventional echocardiographic evaluation. The subjects were divided into two groups according to their vitamin D concentrations. 61 subjects with vitamin D less than 20 ng / ml were included in the vitamin D deficiency group. The baseline clinical characteristics, laboratory measurements, echocardiographic data, including 2D and 3D global longitudinal strain (GLS) values, were compared between the groups. RESULTS The 2D GLS values of the subjects with vitamin D deficiency were lower (mathematically less negative) than subjects with normal vitamin D (-16.1±3.4 vs -19.3±4.2, p<0.001). Similarly, the 3D GLS results were lower in subjects with vitamin D deficiency (-18.3±5.2 vs -24.1±6.9, p<0.001). A significant correlation was detected between the vitamin D concentrations and the 2D and 3D GLS measurements. (r=0.765 and r=0.628, respectively, p<0.001). Vitamin D was found to be an independent predictor of impaired 2D and 3D LV GLS (p=0.031, p=0.023, respectively). CONCLUSION Subclinical LV dysfunction in healthy individuals with vitamin D deficiency was demonstrated by 3D and 2D strain analysis. Due to potential negative effects of vitamin D deficiency on cardiac function, more attention should be paid to healthy individuals with vitamin D deficiency.
Collapse
Affiliation(s)
| | | | - Türkan Seda Tan
- Ankara University, Faculty of Medicine, Department of Cardiology
| | - Aynur Acıbuca
- Ankara University, Faculty of Medicine, Department of Cardiology
| | - Nazlı Turan
- Ankara University, Faculty of Medicine, Department of Cardiology
| | - Rıfat Emral
- Ankara University, Faculty of Medicine, Department of Endocrinology
| | - Irem Dincer
- Ankara University, Faculty of Medicine, Department of Cardiology
| | - Cetin Erol
- Ankara University, Faculty of Medicine, Department of Cardiology
| |
Collapse
|
3
|
Szabo TM, Nagy EE, Kirchmaier Á, Heidenhoffer E, Gábor-Kelemen HL, Frăsineanu M, Cseke J, Germán-Salló M, Frigy A. Total 25-Hydroxyvitamin D Is an Independent Marker of Left Ventricular Ejection Fraction in Heart Failure with Reduced and Mildly Reduced Ejection Fraction. Biomolecules 2023; 13:1578. [PMID: 38002259 PMCID: PMC10669750 DOI: 10.3390/biom13111578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/12/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Vitamin D emerged as an important prognostic biomarker in heart failure (HF), with currently highly debated therapeutic implications. Several trials on vitamin D supplementation in HF showed improvements in left ventricular (LV) remodeling and function and health-related quality of life (HRQoL), which did not translate into mid- to long-term beneficial effects regarding physical performance and mortality. We addressed total 25-hydroxyvitamin D (25(OH)D), serum albumin, and uric acid (UA) levels, focusing mainly on vitamin D deficiency, as potential markers of LV systolic dysfunction in HF with reduced and mildly reduced ejection fraction (HFrEF, HFmrEF). Seventy patients with LVEF < 50% were comprehensively evaluated using ECG, echocardiography, lung ultrasound (LUS), blood sampling, and the six-minute walk test (6MWT). HRQoL was also assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Statistically significant positive correlations were found between LVEF, 25(OH)D, serum UA, and albumin, respectively (p = 0.008, p = 0.009, and p = 0.001). Serum UA (7.4 ± 2.4 vs. 5.7 ± 2.1, p = 0.005), NT-proBNP levels (1090.4 (675.2-2664.9) vs. 759.0 (260.3-1474.8), p = 0.034), and MLHFQ scores (21.0 (14.0-47.0) vs. 14.5 (4.5-25.5), p = 0.012) were significantly higher, whereas 25(OH)D concentrations (17.6 (15.1-28.2) vs. 22.7 (19.5-33.8), p = 0.010) were lower in subjects with severely reduced LVEF. Also, 25(OH)D was independently associated with LVEF in univariate and multiple regression analysis, maintaining its significance even after adjusting for confounders such as age, NT-proBNP, the presence of chronic coronary syndrome, hypertension, and anemia. According to our current findings, 25(OH)D is closely associated with LVEF, further supporting the need to establish correct vitamin D supplementation schemes and dietary interventions in HF. The changes in LVEF, 25(OH)D, serum UA, and albumin levels in HFrEF and HFmrEF indicate a similar pathophysiological background.
Collapse
Affiliation(s)
- Timea Magdolna Szabo
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Előd Ernő Nagy
- Department of Biochemistry and Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
- Laboratory of Medical Analysis, Clinical County Hospital Mureș, 540394 Târgu Mureș, Romania
| | - Ádám Kirchmaier
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Erhard Heidenhoffer
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Hunor-László Gábor-Kelemen
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Marius Frăsineanu
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Judit Cseke
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
| | - Márta Germán-Salló
- Department of Internal Medicine III, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Attila Frigy
- Department of Cardiology, Clinical County Hospital Mureș, 540103 Târgu Mureș, Romania; (Á.K.); (E.H.); (H.-L.G.-K.); (M.F.); (J.C.); (A.F.)
- Department of Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| |
Collapse
|
4
|
Hagău AC, Pușcaș A, Togănel R, Muntean I. Is Hypovitaminosis D a Risk Factor for Heart Failure? Life (Basel) 2023; 13:life13020372. [PMID: 36836729 PMCID: PMC9967471 DOI: 10.3390/life13020372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Several studies in recent years have shown the association between vitamin D levels and heart failure. Vitamin D deficiency is related to increased cardiovascular morbidity and mortality, with a higher risk of developing heart failure. In this systematic review, we aimed to assess recent studies that analyzed vitamin D deficiency and heart failure in adult and pediatric populations. (2) Methods: We conducted a systematic search for studies published in the following databases: PubMed and Scopus from January 2012 to October 2022. (3) Results: Most observational studies that were included found a significant association between hypovitaminosis D and heart failure. However, the beneficial role of vitamin D supplementation is still controversial due to the lack of randomized controlled trials. (4) Conclusions: Vitamin D may play an important role as a cardiovascular marker in heart failure patients. More well-designed studies are needed to investigate the relationship between vitamin D and heart failure and to determine if vitamin D supplementation could improve long-term outcomes.
Collapse
Affiliation(s)
- Asmaa Carla Hagău
- Doctoral School of Medicine and Pharmacy, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540136 TarguMures, Romania
| | - Amalia Pușcaș
- Department of Biochemistry and Chemistry of Environmental Factors, Faculty of Pharmacy, University of Medicine, Pharmacy, Science and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Rodica Togănel
- Department of Paediatrics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Iolanda Muntean
- Clinic of Paediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Târgu Mureș, Romania
- Correspondence: ; Tel.: +40-744372276
| |
Collapse
|
5
|
A pathway phenotype linking metabolic, immune, oxidative, and opioid pathways with comorbid depression, atherosclerosis, and unstable angina. CNS Spectr 2022; 27:676-690. [PMID: 34039448 DOI: 10.1017/s1092852921000432] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is strong comorbidity between atherosclerosis (ATS) and depression which is attributed to increased atherogenicity, insulin resistance (IR), and immune and oxidative stress. AIM OF THE STUDY To examine the role of the above pathways and mu-opioid receptor (MOR), β-endorphin levels, zinc, copper, vitamin D3, calcium, and magnesium in depression due to ATS/unstable angina (UA). METHODS Biomarkers were assayed in 58 controls and 120 ATS patients divided into those with moderate and severe depression according to the Beck Depression Inventory-II (BDI-II) scores >19 and >29, respectively. RESULTS Neural network and logistic regression models showed that severe depression due to ATS/UA was best predicted by interleukin-6 (IL-6), UA, MOR, zinc, β-endorphin, calcium and magnesium, and that moderate depression was associated with IL-6, zinc, MOR, β-endorphin, UA, atherogenicity, IR, and calcium. Neural networks yielded a significant discrimination of severe and moderate depression with an area under the receiver operating curves of 0.831 and 0.931, respectively. Using Partial Least Squares path analysis, we found that 66.2% of the variance in a latent vector extracted from ATS/UA clinical features, and the BDI-II scores, atherogenicity, and IR could be explained by the regression on IL-6, IL-10, zinc, copper, calcium, MOR, and age. The BDI-II scores increased from controls to ATS to UA class III to UA class IV. CONCLUSIONS Immune activation, the endogenous opioid system, antioxidants, trace elements, and macrominerals modulate a common core shared by increased depressive symptoms, ATS, UA, atherogenicity, and IR.
Collapse
|
6
|
Binnenmars SH, Hoogslag GE, Yeung SMH, Brouwers FP, Bakker SJL, van Gilst WH, Gansevoort RT, Navis G, Voors AA, de Borst MH. Fibroblast Growth Factor 23 and Risk of New Onset Heart Failure With Preserved or Reduced Ejection Fraction: The PREVEND Study. J Am Heart Assoc 2022; 11:e024952. [PMID: 35876420 PMCID: PMC9375507 DOI: 10.1161/jaha.121.024952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The role of fibroblast growth factor 23 (FGF23) in the development of new‐onset heart failure (HF) with reduced (HFrEF) or preserved ejection fraction (HFpEF) in the general population is unknown. Therefore, we set out to investigate associations of C‐terminal FGF23 with development of new‐onset HF and, more specifically, with HFrEF or HFpEF in a large, prospective, population‐based cohort. Methods and Results We studied 6830 participants (aged 53.8±12.1 years; 49.7% men; estimated glomerular filtration rate, 93.1±15.7 mL/min per 1.73 m2) in the community‐based PREVEND (Prevention of Renal and Vascular End‐Stage Disease) study who were free of HF at baseline. Cross‐sectional multivariable linear regression analysis showed that ferritin (standardized β, −0.24; P<0.001) and estimated glomerular filtration rate (standardized β, −0.13; P<0.001) were the strongest independent correlates of FGF23. Multivariable Cox proportional hazard regression was used to study the association between baseline FGF23 and incident HF, HFrEF (ejection fraction ≤40%) or HFpEF (ejection fraction ≥50%). After median follow‐up of 7.4 [IQR 6.9–7.9] years, 227 individuals (3.3%) developed new‐onset HF, of whom 132 had HFrEF and 88 had HFpEF. A higher FGF23 level was associated with an increased risk of incident HF (fully adjusted hazard ratio, 1.29 [95% CI, 1.06–1.57]) and with an increased risk of incident HFrEF (fully adjusted hazard ratio, 1.31 [95% CI, 1.01–1.69]). The association between FGF23 and incident HFpEF lost statistical significance after multivariable adjustment (hazard ratio, 1.22 [95% CI, 0.87–1.71]). Conclusions Higher FGF23 is independently associated with new‐onset HFrEF in analyses fully adjusted for cardiovascular risk factors and other potential confounders. The association between FGF23 and incident HFpEF lost statistical significance upon multivariable adjustment.
Collapse
Affiliation(s)
- S Heleen Binnenmars
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Georgette E Hoogslag
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Stanley M H Yeung
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Frank P Brouwers
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Wiek H van Gilst
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Adriaan A Voors
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| |
Collapse
|
7
|
Schepisi G, Gianni C, Bleve S, De Padova S, Menna C, Lolli C, Filograna A, Conteduca V, Urbini M, Gallà V, Casadei C, Rosti G, De Giorgi U. Vitamin D Deficiency in Testicular Cancer Survivors: A Systematic Review. Int J Mol Sci 2021; 22:5145. [PMID: 34067977 PMCID: PMC8152282 DOI: 10.3390/ijms22105145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Testicular cancer (TC) is the most frequent tumor in young males. In the vast majority of cases, it is a curable disease; therefore, very often patients experience a long survival, also due to their young age at diagnosis. In the last decades, the role of the vitamin D deficiency related to orchiectomy has become an increasingly debated topic. Indeed, vitamin D is essential in bone metabolism and many other metabolic pathways, so its deficiency could lead to various metabolic disorders especially in long-term TC survivors. In our article, we report data from studies that evaluated the incidence of hypovitaminosis D in TC survivors compared with cohorts of healthy peers and we discuss molecular mechanisms and clinical implications.
Collapse
Affiliation(s)
- Giuseppe Schepisi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Sara Bleve
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Silvia De Padova
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy;
| | - Cecilia Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Cristian Lolli
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Alessia Filograna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Vincenza Conteduca
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Milena Urbini
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy;
| | - Valentina Gallà
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy;
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Giovanni Rosti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Via P. Maroncelli 40, 47014 Meldola, Italy; (C.G.); (S.B.); (C.M.); (C.L.); (A.F.); (V.C.); (C.C.); (G.R.); (U.D.G.)
| |
Collapse
|
8
|
Tamayo M, Martín-Nunes L, Val-Blasco A, G M-Piedras MJ, Navarro-García JA, Lage E, Prieto P, Ruiz-Hurtado G, Fernández-Velasco M, Delgado C. Beneficial effects of paricalcitol on cardiac dysfunction and remodelling in a model of established heart failure. Br J Pharmacol 2020; 177:3273-3290. [PMID: 32154912 DOI: 10.1111/bph.15048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND PURPOSE The synthetic vitamin D3 analogue paricalcitol acts as a selective activator of the vitamin D receptor (VDR). While there is evidence for cardioprotective effects of paricalcitol associated with the VDR pathway, less information is available about the structural and functional cardiac effects of paricalcitol on established heart failure (HF) and particularly its effects on associated electrophysiological or Ca2+ handling remodelling. EXPERIMENTAL APPROACH We used a murine model of transverse aortic constriction (TAC) to study the effect of paricalcitol on established HF. Treatment was initiated 4 weeks after surgery over five consecutive weeks, and mice were sacrificed 9 weeks after surgery. Cardiac MRI (CMRI) was performed 4 and 9 weeks after surgery. Hearts were used for biochemical and histological studies and to isolate ventricular myocytes for electrophysiological and calcium imaging studies. KEY RESULTS CMRI analysis revealed that, compared with vehicle, paricalcitol treatment prevented the progression of ventricular dilation and hypertrophy after TAC and halted the corresponding decline in ejection fraction. These beneficial effects were related to the attenuation of intracellular Ca2+ mishandling remodelling, antifibrotic and antihypertrophic effects and potentially antiarrhythmic effects by preventing the reduction of K+ current density and the long QT, JT and TpTe intervals observed in HF animals. CONCLUSION AND IMPLICATIONS The results suggest that paricalcitol treatment in established HF hampers disease progression and improves adverse electrophysiological and Ca2+ handling remodelling, attenuating the vulnerability to HF-associated ventricular arrhythmias. Paricalcitol may emerge as a potential therapeutic option in the treatment of HF.
Collapse
Affiliation(s)
- María Tamayo
- Department of Metabolism and Cell Signalling, Biomedical Research Institute "Alberto Sols" CSIC-UAM/CIBER-CV, Madrid, Spain
| | - Laura Martín-Nunes
- Department of Metabolism and Cell Signalling, Biomedical Research Institute "Alberto Sols" CSIC-UAM/CIBER-CV, Madrid, Spain
| | - Almudena Val-Blasco
- Innate Immune Response Group, IdiPAZ/CIBER-CV, La Paz University Hospital, Madrid, Spain
| | - Maria José G M-Piedras
- Department of Anatomy, Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - José Alberto Navarro-García
- Cardiorenal Translational Laboratory, Institute of Research i+12/CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Eduardo Lage
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Patricia Prieto
- Department of Metabolism and Cell Signalling, Biomedical Research Institute "Alberto Sols" CSIC-UAM/CIBER-CV, Madrid, Spain
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Institute of Research i+12/CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Carmen Delgado
- Department of Metabolism and Cell Signalling, Biomedical Research Institute "Alberto Sols" CSIC-UAM/CIBER-CV, Madrid, Spain
| |
Collapse
|
9
|
Traghella I, Mastorci F, Pepe A, Pingitore A, Vassalle C. Nontraditional Cardiovascular Biomarkers and Risk Factors: Rationale and Future Perspectives. Biomolecules 2018; 8:E40. [PMID: 29914099 PMCID: PMC6023023 DOI: 10.3390/biom8020040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 12/13/2022] Open
Abstract
The primary prevention of cardiovascular (CV) disease depends on the capacity to identify subjects at higher risk long before the occurrence of CV clinical manifestations. Traditional risk factors do not cover fully prediction of individual risk. Moreover, there is an area of gray for patients at intermediate CV risk, which offers wide margins of improvement. These observations highlight the need for new additive tools for a more accurate risk stratification. An increasing number of candidate biomarkers have been identified to predict CV risk and events, although they generally give only a moderate increase when added to currently available predictive scores. The approach utilizing a relative small number of biomarkers in multiple combinations, but only weakly related to each other or unrelated, thus belonging to independent-pathways, and so able to catch the multidimensional characteristic of atherosclerosis, appears promising. We discuss vitamin D and bone turnover biomarkers, hepatitis C virus, and psycho-emotional factors that may reflect alternative pathways over those generally considered for atherosclerosis (e.g., aspects directly related to inflammation and thrombosis). These new biomarkers could facilitate a more accurate assessment of CV risk stratification if incorporated in the current risk assessment algorithms.
Collapse
Affiliation(s)
- Irene Traghella
- Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi, 1, 56124 Pisa, Italy.
| | - Francesca Mastorci
- Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi, 1, 56124 Pisa, Italy.
| | - Alessia Pepe
- Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi, 1, 56124 Pisa, Italy.
| | - Alessandro Pingitore
- Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi, 1, 56124 Pisa, Italy.
| | - Cristina Vassalle
- Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi, 1, 56124 Pisa, Italy.
| |
Collapse
|
10
|
Jarrah MI, Mhaidat NM, Alzoubi KH, Alrabadi N, Alsatari E, Khader Y, Bataineh MF. The association between the serum level of vitamin D and ischemic heart disease: a study from Jordan. Vasc Health Risk Manag 2018; 14:119-127. [PMID: 29928126 PMCID: PMC6003285 DOI: 10.2147/vhrm.s167024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Decreased levels of vitamin D were associated with increased risk of multiple diseases, including cardiovascular diseases. However, there seem to be some discrepancies among the results obtained from different studies. The aim of the present study was to explore the importance of having sufficient serum levels of vitamin D in reducing the incidence and the progression of coronary artery stenosis and ischemic heart disease (IHD). Methods Serum levels of vitamin D were measured using radioimmunoassay in 186 Jordanian patients who underwent investigative coronary catheterization. Of these patients, 133 were suffering from coronary artery stenosis. The association between vitamin D levels, coronary stenosis and many risk factors was determined using SPSS software. Results and conclusions Interestingly, the current results did not show an association between vitamin D abnormalities and the incidence or the reoccurrence of coronary artery stenosis. Moreover, significant differences were detected in the prevalence of vitamin D abnormalities based on the patient’s gender, and there was a significant association between vitamin D abnormalities and both body mass index and dyslipidemia. However, current results did not show any significant association with other risk factors for IHD. For instance, no association was found with smoking, hypertension, diabetes mellitus, stable and unstable angina or with acute recent myocardial infarction.
Collapse
Affiliation(s)
- Mohamad I Jarrah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nizar M Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Enas Alsatari
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Moath F Bataineh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, Hashemite University, Zarqa, Jordan
| |
Collapse
|
11
|
Nappi L, Ottaviano M, Rescigno P, Fazli L, Gleave ME, Damiano V, De Placido S, Palmieri G. Long term deficiency of vitamin D in germ cell testicular cancer survivors. Oncotarget 2018; 9:21078-21085. [PMID: 29765521 PMCID: PMC5940414 DOI: 10.18632/oncotarget.24925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 12/05/2017] [Indexed: 12/16/2022] Open
Abstract
Background Cisplatin-based chemotherapy significantly improved the survival of patients with germ cell testicular cancer. However, long term side effects of chemotherapy have non-negligible impact on the quality of life of these young patients, who have a long life expectancy after being successfully treated. Materials and Methods 25-OH vitamin D, testosterone, FSH and LH of patients with testicular cancer were retrospectively evaluated and for each patient clinical information were collected. The tissue of 52 patients with germ cell tumors was analyzed for VDR expression by immunohistochemistry. The serum 25-OH vitamin D and VDR expression were correlated to the patients 'clinical characteristics. Results 25-OH vitamin D was analyzed in 82 patients. Insufficient (< 30 ng/ml) levels were detected in 65%-85%, mild deficient (< 20 ng/ml) in 25%-36% and severe deficient (< 10 ng/ml) in 6%-18% of the patients over a median follow-up of 48 months. No difference in serum 25-OH vitamin D was detected over the follow-up time points. No correlation with histology, stage and type of treatment was found. The 25-OH vitamin D levels were not correlated to testosterone, FSH and LH levels. Interestingly, the expression of VDR was much higher in non seminoma than in seminoma tissue. Conclusions Patients with testicular cancer have reduced vitamin D levels after the treatment of the primary cancer. Since long term hypovitaminosis D leads to high risk of fractures, infertility and cardiovascular diseases, we envision that vitamin D should be regularly checked in patients with testicular cancer and replaced if needed.
Collapse
Affiliation(s)
- Lucia Nappi
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Margaret Ottaviano
- Department of Medicine and Surgery, Division of Medical Oncology, Centro di Riferimento Tumori Rari Regione Campania, University of Naples "Federico II", Napoli, Italy
| | - Pasquale Rescigno
- Department of Medicine and Surgery, Division of Medical Oncology, Centro di Riferimento Tumori Rari Regione Campania, University of Naples "Federico II", Napoli, Italy.,The Institute of Cancer Research, Prostate Targeted Therapy Group, Sutton, UK
| | - Ladan Fazli
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Martin E Gleave
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Vincenzo Damiano
- Department of Medicine and Surgery, Division of Medical Oncology, Centro di Riferimento Tumori Rari Regione Campania, University of Naples "Federico II", Napoli, Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Giovannella Palmieri
- Department of Medicine and Surgery, Division of Medical Oncology, Centro di Riferimento Tumori Rari Regione Campania, University of Naples "Federico II", Napoli, Italy
| |
Collapse
|
12
|
Separham A, Pourafkari L, Kazemi B, Haghizadeh Y, Akbarzadeh F, Toufan M, Sate H, Nader ND. Vitamin D deficiency and functional response to CRT in heart failure patients. Herz 2017; 44:147-154. [DOI: 10.1007/s00059-017-4630-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 01/07/2023]
|
13
|
Tamayo M, Manzanares E, Bas M, Martín-Nunes L, Val-Blasco A, Jesús Larriba M, Fernández-Velasco M, Delgado C. Calcitriol (1,25-dihydroxyvitamin D3) increases L-type calcium current via protein kinase A signaling and modulates calcium cycling and contractility in isolated mouse ventricular myocytes. Heart Rhythm 2017; 14:432-439. [DOI: 10.1016/j.hrthm.2016.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Indexed: 11/26/2022]
|
14
|
Pérez-Hernández N, Aptilon-Duque G, Nostroza-Hernández MC, Vargas-Alarcón G, Rodríguez-Pérez JM, Blachman-Braun R. Vitamin D and its effects on cardiovascular diseases: a comprehensive review. Korean J Intern Med 2016; 31:1018-1029. [PMID: 27117316 PMCID: PMC5094929 DOI: 10.3904/kjim.2015.224] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/10/2015] [Indexed: 12/15/2022] Open
Abstract
Vitamin D is a molecule that is actively involved in multiple metabolic pathways. It is mostly known for its implications related to calcium metabolism. It has also been determined that it actively participates in the cardiovascular system, influencing blood pressure, coronary artery disease and other vascular diseases, such as heart failure and atrial fibrillation. Furthermore, it has been established that this vitamin is extensively involved in the regulation of both the renin angiotensin aldosterone system and the immune system. In this review, we present the different vitamin D metabolic pathways associated with the cardiovascular pathophysiology, and we include studies in animal and human models, as well as some of the controversies found in the literature. This review also incorporates an overview of the implications in the molecular biology and public health fields.
Collapse
Affiliation(s)
- Nonanzit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Nonanzit Pérez-Hernández, Ph.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
| | - Gad Aptilon-Duque
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
| | | | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
| | | | - Ruben Blachman-Braun
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
- Correspondence to Ruben Blachman-Braun, M.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
| |
Collapse
|
15
|
Lutsey PL, Parrinello CM, Misialek JR, Hoofnagle AN, Henderson CM, Laha TJ, Michos ED, Eckfeldt JH, Selvin E. Short-term Variability of Vitamin D-Related Biomarkers. Clin Chem 2016; 62:1647-1653. [PMID: 27694392 DOI: 10.1373/clinchem.2016.261461] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/19/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Quantifying the variability of biomarkers is important, as high within-person variability can lead to misclassification of individuals. Short-term variability of important markers of vitamin D metabolism is relatively unknown. METHODS A repeatability study was conducted in 160 Atherosclerosis Risk in Communities study participants (60% female, 28% black, mean age 76 years). Fasting serum was drawn at 2 time points, a median of 6 (range 3-13) weeks apart. Vitamin D binding protein (VDBP) and 25-hydroxyvitamin D [25(OH)D] were measured by LC-MS, fibroblast growth factor (FGF23) and parathyroid hormone (PTH) by enzyme-linked immunoassay, and calcium and phosphorus by Roche Cobas 6000. Free and bioavailable 25(OH)D were calculated. We calculated the within-person CV (CVW), intraclass correlation coefficient (ICC), Spearman rank correlation coefficient (r), and percent reclassified. RESULTS The CVW was lowest for calcium (2.0%), albumin (3.6%), 25(OH)D (6.9%), VDBP (7.0%) and phosphorus (7.6%); intermediate for free 25(OH)D (9.0%) and bioavailable 25(OH)D (9.9%); and highest for PTH (16.7%) and FGF23 (17.8%). Reclassification was highest for PTH, VDBP, and phosphorus (all 7.5%). The ICC and r were highest (≥0.80) for 25(OH)D, free 25(OH)D, bioavailable 25(OH)D and PTH, but somewhat lower (approximately 0.60-0.75) for the other biomarkers. CONCLUSIONS Six-week short-term variability, as assessed by CVW, was quite low for VDBP, calcium and phosphorus, but fairly high for FGF23 and PTH. As such, multiple measurements of FGF23 and PTH may be needed to minimize misclassification. These results provide insight into the extent of potential misclassification of vitamin D markers in research and clinical settings.
Collapse
Affiliation(s)
- Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN;
| | - Christina M Parrinello
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Jeffrey R Misialek
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Andy N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Clark M Henderson
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Thomas J Laha
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, MD.,Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - John H Eckfeldt
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
16
|
Serum NT-proBNP Levels Are Not Related to Vitamin D Status in Young Patients with Congenital Heart Defects. DISEASE MARKERS 2016; 2016:3970284. [PMID: 26955207 PMCID: PMC4756139 DOI: 10.1155/2016/3970284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/01/2015] [Accepted: 11/04/2015] [Indexed: 12/11/2022]
Abstract
CONTEXT Hypovitaminosis D frequently occurs in early life and increases with age. Vitamin D has been suggested to influence cardiac performance and N-terminal-pro-type B natriuretic peptide (NT-proBNP) release in adults with heart failure. OBJECTIVES To assess the vitamin D status and the impact of hypovitaminosis D on circulating NT-proBNP levels in young patients with congenital heart defects (CHD). DESIGN AND PATIENTS This cross-sectional study included the assessment of serum 25-hydroxyvitamin D (25OHD), parathyroid function markers, and NT-proBNP levels in a series of 230 young in-patients (117 females, 113 males; 6.4 (4.0-9.1) years (median, interquartile range)) with CHD. RESULTS Serum 25OHD levels <20 ng/mL were detected in 55.3% of patients. Optimal 25OHD levels (>30 ng/mL) occurred in 25% of patients. Serum 25OHD levels inversely correlated with age (r = -0.169, P = 0.013) and height standard deviation score (r = -0.269, P = 0.001). After correction for age, 25OHD negatively correlated with serum PTH levels (β = -0.200, P = 0.002). PTH levels above the upper quartile (44 pg/mL) occurred in 32% of hypovitaminosis D patients. Serum NT-proBNP levels were not correlated with 25OHD and PTH levels. CONCLUSIONS Half of the young CHD patients were diagnosed with 25OHD deficiency and a third of hypovitaminosis D patients experienced hyperparathyroidism. Nonetheless, serum NT-proBNP levels were not associated with hypovitaminosis D as well as hyperparathyroidism.
Collapse
|
17
|
Koller L, Kleber ME, Brandenburg VM, Goliasch G, Richter B, Sulzgruber P, Scharnagl H, Silbernagel G, Grammer TB, Delgado G, Tomaschitz A, Pilz S, Berger R, Mörtl D, Hülsmann M, Pacher R, März W, Niessner A. Fibroblast Growth Factor 23 Is an Independent and Specific Predictor of Mortality in Patients With Heart Failure and Reduced Ejection Fraction. Circ Heart Fail 2015; 8:1059-67. [PMID: 26273098 DOI: 10.1161/circheartfailure.115.002341] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 08/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Strategies to improve risk prediction are of major importance in patients with heart failure (HF). Fibroblast growth factor 23 (FGF-23) is an endocrine regulator of phosphate and vitamin D homeostasis associated with an increased cardiovascular risk. We aimed to assess the prognostic effect of FGF-23 on mortality in HF patients with a particular focus on differences between patients with HF with preserved ejection fraction and patients with HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS FGF-23 levels were measured in 980 patients with HF enrolled in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study including 511 patients with HFrEF and 469 patients with HF with preserved ejection fraction and a median follow-up time of 8.6 years. FGF-23 was additionally measured in a second cohort comprising 320 patients with advanced HFrEF. FGF-23 was independently associated with mortality with an adjusted hazard ratio per 1-SD increase of 1.30 (95% confidence interval, 1.14-1.48; P<0.001) in patients with HFrEF, whereas no such association was found in patients with HF with preserved ejection fraction (for interaction, P=0.043). External validation confirmed the significant association with mortality with an adjusted hazard ratio per 1 SD of 1.23 (95% confidence interval, 1.02-1.60; P=0.027). FGF-23 demonstrated an increased discriminatory power for mortality in addition to N-terminal pro-B-type natriuretic peptide (C-statistic: 0.59 versus 0.63) and an improvement in net reclassification index (39.6%; P<0.001). CONCLUSIONS FGF-23 is independently associated with an increased risk of mortality in patients with HFrEF but not in those with HF with preserved ejection fraction, suggesting a different pathophysiologic role for both entities.
Collapse
Affiliation(s)
- Lorenz Koller
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Marcus E Kleber
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Vincent M Brandenburg
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Georg Goliasch
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Bernhard Richter
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Patrick Sulzgruber
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Hubert Scharnagl
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Günther Silbernagel
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Tanja B Grammer
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Graciela Delgado
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Andreas Tomaschitz
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Stefan Pilz
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Rudolf Berger
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Deddo Mörtl
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Martin Hülsmann
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Richard Pacher
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Winfried März
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.)
| | - Alexander Niessner
- From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (L.K., G.G., B.R., P.S., R.B., D.M., M.H., R.P., A.N.); Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology) (M.E.K., T.B.G., G.D., W.M.) and Mannheim Institute of Public Health, Social and Preventive Medicine (T.B.G.), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany; Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B.); Clinical Institute of Medical and Chemical Laboratory Diagnostics (G.S.), Division of Cardiology (A.T.) and Division of Endocrinology and Metabolism (S.P.), Department of Internal Medicine, Medical University of Graz, Graz, Austria (H.S., W.M.); Department of Angiology, Inselspital, Bern, Switzerland; Sonderkrankenanstalt Rehabilitationszentrum Bad Aussee: Specialist Clinic for Rehabilitation, PV Bad Aussee, Austria (A.T.); and Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.).
| |
Collapse
|
18
|
Levy PD. Guilt by Association--A Closer Look at Calcium, Heart Failure, and Mortality. J Card Fail 2015; 21:628-9. [PMID: 26037153 DOI: 10.1016/j.cardfail.2015.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 05/26/2015] [Accepted: 05/26/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Phillip D Levy
- Emergency Medicine, Wayne State University, Detroit, Michigan.
| |
Collapse
|
19
|
Lutsey PL, Michos ED, Misialek JR, Pankow JS, Loehr L, Selvin E, Reis JP, Gross M, Eckfeldt JH, Folsom AR. Race and Vitamin D Binding Protein Gene Polymorphisms Modify the Association of 25-Hydroxyvitamin D and Incident Heart Failure: The ARIC (Atherosclerosis Risk in Communities) Study. JACC-HEART FAILURE 2015; 3:347-356. [PMID: 25863973 DOI: 10.1016/j.jchf.2014.11.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/19/2014] [Accepted: 11/24/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study sought to determine if low serum 25-hydroxyvitamin D (25[OH]D) is associated with incident heart failure (HF) and if the association is: 1) partly mediated by traditional cardiovascular risk factors; 2) stronger among whites than blacks; and 3) stronger among those genetically predisposed to having high levels of vitamin D binding protein (DBP). BACKGROUND Suboptimal 25(OH)D is a potential cardiovascular risk factor. METHODS A total of 12,215 ARIC (Atherosclerosis Risk in Communities) study participants free of HF at baseline (1990 to 1992; median age, 56; 24% black) were followed through 2010. Total serum 25(OH)D was measured at baseline using liquid chromatography-mass spectrometry. Incident HF events were identified by a hospital discharge code of ICD9-428 and parallel International Classification of Diseases codes for HF deaths. RESULTS During 21 years of follow-up, 1,799 incident HF events accrued. The association between 25(OH)D and HF varied by race (p-interaction = 0.02). Among whites, risk was 2-fold higher for those in the lowest (≤17 ng/ml) versus highest (≥31 ng/ml) quintile of 25(OH)D. The association was attenuated but remained significant with covariate adjustment. In blacks there was no overall association. In both races, those with low 25(OH)D and the rs7041 G allele, which predisposes to high DBP, were at greater risk (p-interaction = 0.01). CONCLUSIONS Low serum 25(OH)D was independently associated with incident HF among whites, but not among blacks. However, in both races, low 25(OH)D was associated with HF risk among those genetically predisposed to high DBP. These findings provide novel insight into metabolic differences that may underlie racial variation in the association between 25(OH)D and cardiovascular risk.
Collapse
Affiliation(s)
- Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - Jeffrey R Misialek
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Laura Loehr
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth Selvin
- Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Myron Gross
- Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - John H Eckfeldt
- Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
20
|
Raghban A, Kirsop J, Tang WHW. Prevention of Heart Failure in Patients with Chronic Kidney Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2015; 9:428. [PMID: 38993263 PMCID: PMC11238633 DOI: 10.1007/s12170-014-0428-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Patients with chronic kidney disease (CKD) have heightened risk of developing heart failure (HF), yet few clinical studies have directly investigated the pathophysiologic underpinnings or therapeutic strategies to prevent HF. A wide range of clinically available cardiac and renal biomarkers can identify at-risk individuals who would benefit from dietary and lifestyle modifications (exercise prescription, smoking cessation), as well as risk factor modification (blood pressure, glucose, and lipid control). Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have the most consistent data for risk reduction, while other standard HF drugs such as beta-blockers and mineralocorticoid receptor antagonists have promising findings but no large-scale clinical trial evidence for their routine use to prevent the development and progression of HF in this vulnerable population.
Collapse
Affiliation(s)
- Amr Raghban
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA
| | - Jennifer Kirsop
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA
| |
Collapse
|
21
|
Challoumas D. Vitamin D supplementation and lipid profile: what does the best available evidence show? Atherosclerosis 2014; 235:130-9. [PMID: 24835432 DOI: 10.1016/j.atherosclerosis.2014.04.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/10/2014] [Accepted: 04/13/2014] [Indexed: 01/14/2023]
Abstract
Vitamin D supplements have increasingly been used for the treatment and prevention of osteoporosis. Historically, effects of the vitamin on the cardiovascular (CV) system have been proposed and demonstrated in the literature, including benefits on serum lipids. Although observational studies support an association between increased serum vitamin D levels and a favorable lipid profile, interventional studies have shown no effects. This review presents and analyzes all the related randomized controlled trials (RCTs) identified in the literature from 1987 to present. A systematic literature search was conducted via MEDLINE, Cochrane Library and EMBASE and, out of 19 relevant RCTs identified, only one reported benefits of vitamin D supplementation on lipid profile parameters, while the rest showed no effects or even adverse outcomes, which are highlighted by the only meta-analysis in the field. Attempts to explain the paradox of beneficial findings of observational studies versus discouraging results of interventional studies have been made and the most popular suggests that high serum vitamin D concentrations may not be the cause of good health but its outcome instead, as healthy people are more likely to stay outdoors longer and have better eating habits. For definitive answers to be given, large, well-designed RCTs need to be conducted that will take into account and adjust for dietary consumption as well as serum calcium and parathyroid hormone levels, both of which have been shown to be associated with the CV system. Until then, recommendations for vitamin D supplementation should not change.
Collapse
Affiliation(s)
- Dimitrios Challoumas
- School of Medicine, Cardiff University, Heath Park Campus, Cardiff CF14 4XW, UK.
| |
Collapse
|