Tags

Type your tag names separated by a space and hit enter

Association between serum 25-hydroxyvitamin D level and subclinical cardiovascular disease in primary hyperparathyroidism.
J Clin Endocrinol Metab. 2014 Feb; 99(2):671-80.JC

Abstract

CONTEXT

Vitamin D (25OHD) deficiency may be a modifiable cardiovascular (CV) risk factor. 25OHD insufficiency (20-29 ng/mL) and deficiency (<20 ng/mL) are common in primary hyperparathyroidism (PHPT), but their association with CV disease in PHPT has not been systematically investigated.

OBJECTIVE

This study evaluated whether low 25OHD is associated with subclinical CV disease in PHPT.

DESIGN

This is a cross-sectional analysis of PHPT patients with and without low 25OHD.

SETTINGS AND PARTICIPANTS

We studied 110 PHPT patients in a university hospital setting.

OUTCOME MEASURES

We measured carotid intima-media thickness; carotid plaque presence/thickness; carotid strain and stiffness; left ventricular mass index; cardiac systolic and diastolic function; and mitral annular calcification.

RESULTS

Low 25OHD levels (<30 ng/mL) were observed in 28%, but only 9% had 25OHD deficiency (<20 ng/mL). In the whole group, 25OHD levels negatively correlated with body mass index (r = -0.33, P = .0005), PTH (r = -0.30, P = .001), calcium (r = -0.29, P = .002), renal function, and PHPT duration. CV indices were normal except for carotid intima-media thickness, stiffness, and plaque thickness, which were increased, regardless of 25OHD status. Isovolumic relaxation time was the only CV measure associated with 25OHD (r = -0.26, P = .01). Those with 25OHD less than 20 ng/mL had more severe PHPT and a higher rate of nephrolithiasis. Those with 25OHD less than 30 ng/mL were younger, had higher body mass index, had lower serum phosphate, and were more likely to be male, nonwhite, and Hispanic. Other than lower tissue Doppler e' and higher isovolumic relaxation time within normal range in those with 25OHD less than 30 vs greater than 30 ng/mL, there were no differences in CV indices using either 25OHD threshold.

CONCLUSIONS

Patients with mild PHPT have subclinical carotid abnormalities, but low 25OHD is not associated with abnormal carotid or cardiac measures. To the extent that PTH levels differentiated those with 25OHD less than 20 but not 30 ng/mL, these data support a 25OHD threshold of 20 ng/mL as clinically relevant in PHPT.

Authors+Show Affiliations

Departments of Medicine (M.D.W., E.C., A.K., M.R.D.T., S.H., R.L., P.Y., C.Z., D.J.M., S.J.S.) and Surgery (J.A.L.), Columbia University, College of Physicians and Surgeons, New York, New York 10032; and Department of Neurology (T.R.), Miller School of Medicine, University of Miami, Miami, Florida 33136.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24285686

Citation

Walker, Marcella D., et al. "Association Between Serum 25-hydroxyvitamin D Level and Subclinical Cardiovascular Disease in Primary Hyperparathyroidism." The Journal of Clinical Endocrinology and Metabolism, vol. 99, no. 2, 2014, pp. 671-80.
Walker MD, Cong E, Kepley A, et al. Association between serum 25-hydroxyvitamin D level and subclinical cardiovascular disease in primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(2):671-80.
Walker, M. D., Cong, E., Kepley, A., Di Tullio, M. R., Rundek, T., Homma, S., Lee, J. A., Liu, R., Young, P., Zhang, C., McMahon, D. J., & Silverberg, S. J. (2014). Association between serum 25-hydroxyvitamin D level and subclinical cardiovascular disease in primary hyperparathyroidism. The Journal of Clinical Endocrinology and Metabolism, 99(2), 671-80. https://doi.org/10.1210/jc.2013-3523
Walker MD, et al. Association Between Serum 25-hydroxyvitamin D Level and Subclinical Cardiovascular Disease in Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(2):671-80. PubMed PMID: 24285686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between serum 25-hydroxyvitamin D level and subclinical cardiovascular disease in primary hyperparathyroidism. AU - Walker,Marcella D, AU - Cong,Elaine, AU - Kepley,Anna, AU - Di Tullio,Marco R, AU - Rundek,Tatjana, AU - Homma,Shunichi, AU - Lee,James A, AU - Liu,Rui, AU - Young,Polly, AU - Zhang,Chiyuan, AU - McMahon,Donald J, AU - Silverberg,Shonni J, Y1 - 2013/11/27/ PY - 2013/11/29/entrez PY - 2013/11/29/pubmed PY - 2014/4/9/medline SP - 671 EP - 80 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 99 IS - 2 N2 - CONTEXT: Vitamin D (25OHD) deficiency may be a modifiable cardiovascular (CV) risk factor. 25OHD insufficiency (20-29 ng/mL) and deficiency (<20 ng/mL) are common in primary hyperparathyroidism (PHPT), but their association with CV disease in PHPT has not been systematically investigated. OBJECTIVE: This study evaluated whether low 25OHD is associated with subclinical CV disease in PHPT. DESIGN: This is a cross-sectional analysis of PHPT patients with and without low 25OHD. SETTINGS AND PARTICIPANTS: We studied 110 PHPT patients in a university hospital setting. OUTCOME MEASURES: We measured carotid intima-media thickness; carotid plaque presence/thickness; carotid strain and stiffness; left ventricular mass index; cardiac systolic and diastolic function; and mitral annular calcification. RESULTS: Low 25OHD levels (<30 ng/mL) were observed in 28%, but only 9% had 25OHD deficiency (<20 ng/mL). In the whole group, 25OHD levels negatively correlated with body mass index (r = -0.33, P = .0005), PTH (r = -0.30, P = .001), calcium (r = -0.29, P = .002), renal function, and PHPT duration. CV indices were normal except for carotid intima-media thickness, stiffness, and plaque thickness, which were increased, regardless of 25OHD status. Isovolumic relaxation time was the only CV measure associated with 25OHD (r = -0.26, P = .01). Those with 25OHD less than 20 ng/mL had more severe PHPT and a higher rate of nephrolithiasis. Those with 25OHD less than 30 ng/mL were younger, had higher body mass index, had lower serum phosphate, and were more likely to be male, nonwhite, and Hispanic. Other than lower tissue Doppler e' and higher isovolumic relaxation time within normal range in those with 25OHD less than 30 vs greater than 30 ng/mL, there were no differences in CV indices using either 25OHD threshold. CONCLUSIONS: Patients with mild PHPT have subclinical carotid abnormalities, but low 25OHD is not associated with abnormal carotid or cardiac measures. To the extent that PTH levels differentiated those with 25OHD less than 20 but not 30 ng/mL, these data support a 25OHD threshold of 20 ng/mL as clinically relevant in PHPT. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/24285686/Association_between_serum_25_hydroxyvitamin_D_level_and_subclinical_cardiovascular_disease_in_primary_hyperparathyroidism_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2013-3523 DB - PRIME DP - Unbound Medicine ER -