Abstract
Introduction: Vitamin D deficiency(VDD) is a common condition in all ages, especially in winter, and causes several adverse outcomes, including cardiovascular diseases. Although there is conflicting information about the causes of cardiac events in VDD, the commonly accepted cause is a pathogenic relationship with hyperparathyroidism.Aim: We aim to demonstrate the effects of hyperparathyroidism, if present, on endothelial and diastolic functions using echocardiography, carotid and brachial tissue Doppler imaging(tDi) in premenopausal women with VDD independent from other confounding risk factors.Methods: Our study is a cross-sectional, observational study investigating premenopausal women aged 18-50 who applied to internal medicine. The patients were divided into two groups according to their parathyroid hormone(PTH) levels. While PTH levels are within the normal range in 41 patients, it was high in 29 patients. Study groups are analyzed for basal characteristics, standard echocardiographic evaluation, carotid, and brachial artery tDi features.Results: There were no significant differences in age, height, weight, body mass index(BMI), and diastolic blood pressures(BP) between the groups(all p values>0.05). Systolic BPs were significantly higher in the secondary hyperparathyroidism, no patients diagnosed with hypertension(Mean systolic BP 124±8, p=0.020). The rate of severe VDD was 78%. In terms of diastolic parameters, prolongation of A wave durations and decreased E/A ratio were observed in the secondary hyperparathyroidism(p values are 0.043 and 0.031, respectively). Carotid and brachial tDi; carotid intima-media thickness(IMT) is significantly higher in secondary hyperparathyroidism(p=0.032).Conclusion: We showed that high PTH levels have adverse effects on diastolic functions(A wave, E/A ratio) and endothelial functions(carotid IMT) in premenopausal women with VDD, even in the absence of other confounding risk factors. We can state that our study's findings will contribute to the literature and are predictive for future studies.