J Korean Med Sci.  2009 Jan;24(Suppl 1):S109-S114. 10.3346/jkms.2009.24.S1.S109.

Vitamin D Levels and Their Relationship with Cardiac Biomarkers in Chronic Hemodialysis Patients

• Hur SJ
• Kim DM
• Lim KH
• Yoon SH
• Chung HC
• Lee JS
• Park J

• KMID: 1778149
• DOI: http://doi.org/10.3346/jkms.2009.24.S1.S109

Abstract

Vitamin D insufficiency may be associated with cardiovascular (CV) mortality in HD patients. To test this hypothesis, we cross-sectionally measured 25-hydroxyvitamin D (25D), 1,25-dihydroxyvitamin D (1,25D), cardiac troponin T (cTnT), and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in chronic HD patients. Sixty-five patients (M:F=31:34, age 52.2+/-13.2 yr, DM 41.5%) were selected. Along with the expected low levels of 1,25D, 59 (90.8%) patients had 25D insufficiency (<30 ng/mL) among whom 15 (23.1%) were 25D deficient (<10 ng/mL). The 25D levels showed a negative correlation with cTnT levels (Spearman's rho=-0.44, p<0.01) but not with NT-pro-BNP levels (Spearman's rho=-0.17, p=0.17). The 1,25D levels, however, did not show any relationship with either cTnT or NT-pro-BNP. In multivariate analysis, being male and having low levels of 25D were independent risk factors associated with cTnT elevation (beta=0.44, p<0.01 and beta=-0.48, p<0.01, respectively). In conclusion, not only 1,25D but also 25D are commonly decreased in HD patients. Lower 25D levels appear to be associated with cTnT elevation, predicting worse CV outcome, and are possible to involve cardiac hypertrophy or coronary artery disease.

Keyword

Cardiovascular Diseases; Renal Dialysis; Troponin; Vitamin D

MeSH Terms

Biological Markers/*blood
Coronary Artery Disease/blood/diagnosis
Electrocardiography/methods
Female
Heart Diseases/*blood/diagnosis
Humans
Male
Middle Aged
Multivariate Analysis
Nerve Tissue Proteins/blood
Protein Precursors/blood
Renal Dialysis/*methods
Risk Factors
Troponin T/blood
Vitamin D/*blood/metabolism

Figure

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  Fig. 1 Distribution of 25D and 1,25D in the study population (n=65). Median 25D concentration was 14.6 ng/mL (IQR 10.4-21.6), and median 1,25D concentration was 3.1 pg/mL (IQR 3.0-4.3).

• 

  Fig. 2 Relationship between 25D concentration and cTnT/NT-pro-BNP levels (n=65). 25D concentration shows negative correlation with cTnT levels but not with NT-pro-BNP levels.

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