Is Normocalcemic Primary Hyperparathyroidism Harmful or Harmless?

2015 ◽  
Vol 100 (6) ◽  
pp. 2420-2424 ◽  
Author(s):  
Gang Chen ◽  
Ying Xue ◽  
Qiongyao Zhang ◽  
Ting Xue ◽  
Jin Yao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Parathyroid Hormone ◽  
Hydroxyvitamin D ◽  
Outcomes Measures ◽  
25 Hydroxyvitamin D ◽  
Serum Pth

Context: Primary hyperparathyroidism (PHPT) is reported to be associated with an increased frequency of hypertension, however, information in this regard is sparse in relation to normocalcemic primary hyperparathyroidism (NPHPT). Objective: The aim of this study was to determine the association between NPHPT and blood pressure. Design, Setting, and Patients: We retrospectively enrolled 940 patients who visited the Fujian Provincial Hospital between September 2010 and December 2013 with a measured serum parathyroid hormone (PTH) and calcium level. Among them, 11 patients were diagnosed with NPHPT, while 296 cases with normal PTH and albumin-adjusted serum calcium. Main Outcomes Measures: Systolic blood pressure (SBP), diastolic blood pressure (DBP), intact serum PTH, and serum calcium were recorded. Results: There were no significant differences between subjects identified with NPHPT and those with normal PTH in terms of age, sex, body mass index, serum calcium, 25-Hydroxyvitamin D, serum creatinine, fasting plasma glucose, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein. The subjects with a diagnosis of NPHPT had higher levels of SBP (141.9 ± 20.2 vs 131.2 ± 16.5, P = .041) and DBP (85.2 ± 12.4 vs 76.8 ± 10.3, P = .026) than the subjects in the cohort with normal PTH. After adjustment for all potential confounders, risks (odds ratios and 95% confidence interval) of SBP and DBP in NPHPT patients were 1.035 (1.000, 1.071) and 1.063 (1.004, 1.125), respectively (P < .05). Conclusions: The NPHPT had higher risk of high blood pressure than subjects with normal PTH. It is worth considering the necessity of more aggressive therapeutic intervention aimed to normalize PTH even if patients with NPHPT continue to be normocalcemic.

scholarly journals Relationship between serum parathyroid hormone, serum calcium and arterial blood pressure in patients with primary hyperparathyroidism: results of a multivariate analysis

2002 ◽  
pp. 643-647 ◽  
Author(s):  
F Lumachi ◽  
M Ermani ◽  
G Luisetto ◽  
A Nardi ◽  
SM Basso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Arterial Blood Pressure ◽  
Serum Calcium ◽  
Biochemical Parameters ◽  
Serum Parathyroid Hormone ◽  
Arterial Blood ◽  
Serum Pth

OBJECTIVE: To evaluate the possible relationship between serum calcium, serum parathyroid hormone (PTH) levels and arterial blood pressure (BP) in patients with primary hyperparathyroidism (HPT). DESIGN: A retrospective population-based study. METHODS: Charts of 194 patients with proven primary HPT were reviewed, and the main clinical and biochemical parameters were recorded. There were 48 men (24.7%) and 146 women (75.3%), with a median age of 59 years (range 23-82 years). Patients who used antihypertensive drugs or hormone replacement therapy had been previously excluded. All patients underwent successful parathyroidectomy, and were cured of their disease. RESULTS: There were no differences (P=NS) between men and women in systolic (143.3+/-19.1 vs 145.4+/-17.1 mmHg) and diastolic (87.1+/-12.3 vs 88.4+/-9.9 mmHg) BP, and in the main biochemical parameters. A significant (P<0.01) correlation was found between (i) serum calcium and serum PTH levels (r=0.39, F=88.36), (ii) age and BP, both systolic (r=0.61, F=118.16) and diastolic (r=0.48, F=64.5), and (iii) body mass index (BMI) and BP (r=0.45 and 0.36 respectively). There was no significant association of serum calcium levels with systolic (r=0.0974, t=1.3422, P=0.18) or diastolic (r=0.1117, t=1.5409, P=0.12) BP, and of serum PTH levels with systolic (r=-0.0349, t=-0.4783, P=0.63) or diastolic (r=-0.0793, t=-1.0913, P=0.28) BP. Multivariate analysis confirmed that none of the independent biochemical parameters significantly correlated with BP, both systolic and diastolic. CONCLUSIONS: In patients with primary HPT there is no relationship between PTH, calcium and BP. Thus, in hyperparathyroid patients, BP should be considered as an independent variable, mainly related to age and BMI.

scholarly journals Vitamin D-Fortified Bread Is as Effective as Supplement in Improving Vitamin D Status: A Randomized Clinical Trial

2016 ◽  
Vol 101 (6) ◽  
pp. 2511-2519 ◽  
Author(s):  
Bahareh Nikooyeh ◽  
Tirang R. Neyestani ◽  
Maliheh Zahedirad ◽  
Mehrdad Mohammadi ◽  
S. Hedayat Hosseini ◽  
...  
Keyword(s):  
Vitamin D ◽  
Controlled Trial ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cholesterol Concentration ◽  
Daily Consumption ◽  
Double Blind ◽  
Hydroxyvitamin D ◽  
Group Reduction ◽  
25 Hydroxyvitamin D

Abstract Context: Bread can potentially be a suitable vehicle for fortification with vitamin D. Objective: This study was undertaken to evaluate the following: 1) the bioavailability of vitamin D from the fortified Iranian bread and 2) the possible effects of daily consumption of the fortified bread on certain health aspects. Design, Setting, and Participants: This was a randomized, double-blind, placebo-controlled trial conducted over 8 weeks in 90 healthy subjects aged 20–60 years. Intervention: Subjects were randomly allocated to one of three groups: 1) fortified bread (FP; 50 g bread fortified with 25 μg vitamin D3 plus placebo daily; n = 30); 2) supplement (SP; 50 g plain bread plus 25 μg vitamin D supplement daily; n = 30); and 3) control (CP; 50 g plain bread plus placebo daily; n = 30). Outcome Measures: Initial and final anthropometric and biochemical assessments were performed. Results: The within-group changes of serum 25-hydroxyvitamin D concentrations were 39.0 ± 22.6 (P &lt; .001), 28.9 ± 31.2 (P &lt; .001), and −9.2 ± 12.3 nmol/L in the FP, SP, and CP groups, respectively. Only in FP and SP groups, serum intact PTH concentrations decreased approximately 13.5% and 14.5%, respectively. Visceral fat also showed a significant decrement in FP (−1.05% ± 1.4%; P ≤ .001) and SP (−0.96% ± 1.7%; P = .006). Serum low-density lipoprotein cholesterol concentration showed a within-group reduction in FP (−10.4 ± 11.2 mg/dL; P &lt; .001) and an insignificant decrement in SP (−6.6 ± 20.2 mg/dL; P = .083). Serum high-density lipoprotein increased in both vitamin D-supplemented groups (FP: 9.7 ± 7.6 vs SP: 5.7 ± 6.7 mg/dL; P &lt; .001). Conclusion: Vitamin D-fortified bread could be potentially effective in raising circulating 25-hydroxyvitamin D levels of the population to nearly adequate levels.

scholarly journals The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

2019 ◽  
Author(s):  
Junzeng Si ◽  
kuibao li ◽  
peiyan shan ◽  
Junliang Yuan
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Small Vessel Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Small Vessel ◽  
Hydroxyvitamin D ◽  
Vessel Disease ◽  
25 Hydroxyvitamin D ◽  
Exact Relationship

Abstract Background: The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such association between 25(OH) D and SVD in China. Methods: We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25(OH) D: vitamin D deficiency (<12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (>20 ng/ml). Results: Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6±13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P=0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P<0.05). Logistic regression analysis revealed the level of 25(OH)D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P=0.001). Compared with the sufficient 25(OH)D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (Pinteraction=0.001). Conclusion: We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

scholarly journals Prolonged treatment with vitamin D in postmenopausal women with primary hyperparathyroidism

2012 ◽  
Vol 1 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Ranganathan R Rao ◽  
Harpal S Randeva ◽  
Sailesh Sankaranarayanan ◽  
Murthy Narashima ◽  
Matthias Möhlig ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Postmenopausal Women ◽  
Prolonged Treatment ◽  
Serum 25Ohd ◽  
Hydroxyvitamin D ◽  
Significant Difference ◽  
25 Hydroxyvitamin D ◽  
Serum Pth

Introduction/backgroundVitamin D deficiency further increases circulating parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism (pHPT), with potential detrimental effects on bone mass.MethodsThis was an observational clinical study in consecutive conservatively treated postmenopausal women (n=40) with pHPT and coexistent 25-hydroxyvitamin D deficiency (25OHD ≤50 nmol/l (≤20 ng/ml)). Patients who showed an increase in serum 25OHD above the threshold of vitamin D deficiency (>50 nmol/l; n=28) using treatment with various commonly prescribed vitamin D preparations were, for the purposes of statistical analyses, allocated to the treatment group. Patients who were retrospectively identified as having received no treatment with vitamin D and/or remained vitamin D deficient were considered as non-responders/controls (n=12). Adjusted calcium (adjCa), PTH and 25OHD concentrations were monitored in all subjects up to 54 months (mean observation period of 18±2 months).ResultsProlonged increased vitamin D intake, regardless of the source (serum 25OHD, increase from 32.2±1.7 nmol/l at baseline to 136.4±11.6 nmol/l, P<0.0001), significantly reduced serum PTH (13.3±1.1 vs 10.5±1.0 pmol/l, P=0.0001), with no adverse effects on adjCa levels (2.60±0.03 vs 2.60±0.02 mmol/l, P=0.77) and renal function tests (P>0.73). In contrast, serum PTH remained unchanged (15.8±2.6 vs 16.3±1.9 pmol/l, P=0.64) in patients who remained vitamin D deficient, with a significant difference between groups in changes of PTH (P=0.0003). Intrapartial correlation analyses showed an independent negative correlation of changes in 25OHD with PTH levels (ric=−0.41, P=0.014).ConclusionsProlonged treatment with vitamin D in various commonly prescribed preparations appeared to be safe and significantly reduced PTH levels by 21%.

Impact of pre-operative serum 25-hydroxyvitamin D on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre: retrospective study of 246 patients

2017 ◽  
Vol 131 (10) ◽  
pp. 925-929 ◽  
Author(s):  
M Erlem ◽  
N Klopp-Dutote ◽  
A Biet-Hornstein ◽  
V Strunski ◽  
C Page
Keyword(s):  
Parathyroid Hormone ◽  
Retrospective Study ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Univariate Analysis ◽  
Multinodular Goitre ◽  
Serum Parathyroid Hormone ◽  
Single Centre ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

AbstractObjective:To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre.Methods:This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia.Results:Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032).Conclusion:Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.

scholarly journals The Risk of All-Cause Mortality Is Inversely Related to Serum 25(OH)D Levels

2012 ◽  
Vol 97 (8) ◽  
pp. 2792-2798 ◽  
Author(s):  
Walid Saliba ◽  
Ofra Barnett ◽  
Hedy S. Rennert ◽  
Gad Rennert
Keyword(s):  
Vitamin D ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Vital Status ◽  
Hydroxyvitamin D ◽  
All Cause Mortality ◽  
General Population Cohort ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

Abstract Context and Objectives: Vitamin D plays a key role in maintaining bone health, but evidence for its nonskeletal effects is inconsistent. This study aims to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and all-cause mortality in a large general population cohort. Design, Participants, and Setting: Using the computerized database of the largest health care provider in Israel, we identified a cohort of subjects 20 years old or older with serum 25(OH)D levels measured between January 2008 and December 2009. Vital status was ascertained through August 2011. Results: Median follow-up was 28.5 months (interquartile range 23.8–33.5 months); 7,247 of 182,152 participants (4.0%) died. Subjects who died had significantly lower serum 25(OH)D levels (mean 44.8 ± 24.2 nmol/liter) than those alive at the end of follow-up (51.0 ± 23.2 nmol/liter), P &lt; 0.001. After adjustment for age, gender, ethnicity, and seasonality, the hazard ratio (HR) for all-cause mortality was 2.02 [95% confidence interval (CI) 1.89–2.15] for the lowest serum 25(OH)D quartile (&lt;33.8 nmol/liter) compared with the highest. After further adjustment for comorbidity, use of vitamin D supplements and statins, smoking, socioeconomic status, and body mass index, the HR was 1.81 (95% CI 1.69–1.95). This remained, even after adjustment for serum low-density lipoprotein, high-density lipoprotein, calcium level (corrected for serum albumin levels), and glomerular filtration rate, 1.85 (95% CI 1.70–2.01). The fully adjusted HR associated with being in the second 25(OH)D quartile (33.8–49.4 nmol/liter) was 1.25 (95% CI 1.16–1.34). Conclusions: All-cause mortality is independently and inversely associated with serum 25(OH)D levels at levels less than 50 nmol/liter.

scholarly journals Assay-Specific Decision Limits for Two New Automated Parathyroid Hormone and 25-Hydroxyvitamin D Assays

2005 ◽  
Vol 51 (2) ◽  
pp. 395-400 ◽  
Author(s):  
Jean-Claude Souberbielle ◽  
Véronique Fayol ◽  
Corinne Sault ◽  
Ethel Lawson-Body ◽  
André Kahan ◽  
...  
Keyword(s):  
Vitamin D ◽  
Regression Analysis ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Healthy Individuals ◽  
Hydroxyvitamin D ◽  
Low Concentrations ◽  
25 Hydroxyvitamin D ◽  
High Concentrations ◽  
Serum Pth

Abstract Background: The recent development of nonradioactive automated assays for serum parathyroid hormone (PTH) and 25-hydroxyvitamin D (25OHD) has made measurement of these two hormones possible in many laboratories. In this study, we compared two new assays for PTH and 25OHD adapted on an automated analyzer, the LIAISON®, with two manual immunoassays used worldwide. Methods: We studied 228 osteoporotic patients, 927 healthy individuals, 38 patients with primary hyperparathyroidism, and 167 hemodialyzed patients. Serum PTH was measured with the Allegro® and the LIAISON assays, and 25OHD was measured with DiaSorin RIA and the LIAISON assay. Regression analysis was used to calculate decision thresholds for the LIAISON assays that were equivalent to those of the Allegro PTH and DiaSorin 25OHD assays. Results: The 25OHD concentrations obtained with the LIAISON assay and the RIA in osteoporotic patients were well correlated (r = 0.83; P &lt;0.001). Regression and Bland–Altman analyses suggested that the LIAISON 25OHD assay reads lower than the DiaSorin RIA at low concentrations but higher at high concentrations. However, the cutoff (50 nmol/L) used in our laboratories to define vitamin D insufficiency with the DiaSorin RIA is applicable to the LIAISON 25OHD assay. In 927 healthy individuals, the 3rd–97th percentile intervals were 3–80 ng/L and 13–151 nmol/L for the LIAISON PTH and 25OHD concentrations, respectively. However, 506 individuals (54.6%) were vitamin D-insufficient; we therefore considered only the 421 individuals with a LIAISON 25OHD &gt;50 nmol/L as eligible for the reference population for the LIAISON PTH assay. In this group, the 3rd–97th percentile interval for LIAISON PTH was 3–51 ng/L. Considering upper reference limits of 46 and 51 ng/L for the Allegro and LIAISON assays, respectively, the frequency of above-normal PTH concentrations in patients with primary hyperparathyroidism was similar in both assays. Regression analysis between serum PTH measured by the Allegro and LIAISON assays in 167 hemodialyzed patients and the corresponding Bland–Altman analysis of these data suggest that the LIAISON PTH assay tends to read higher than the Allegro assay at low concentrations but lower at high concentrations (&gt;300 ng/L). Conclusions: Because clinical decision limits for both PTH and 25OHD should be assay specific, we propose equivalences between these assays and two manual assays used worldwide. These assay-specific decision limits should help potential users of the LIAISON PTH and 25OHD assays.

scholarly journals Serum concentrations of 25-hydroxyvitamin D and its association with bone mineral density and serum parathyroid hormone levels during winter in urban males from Guiyang, Southwest China

2016 ◽  
Vol 115 (6) ◽  
pp. 960-966 ◽  
Author(s):  
Qiao Zhang ◽  
Lixin Shi ◽  
Nianchun Peng ◽  
Shujing Xu ◽  
Miao Zhang ◽  
...  
Keyword(s):  
Southwest China ◽  
Serum Concentrations ◽  
Mineral Density ◽  
Serum Parathyroid Hormone ◽  
Serum 25Ohd ◽  
Hydroxyvitamin D ◽  
Urban Males ◽  
25Ohd Concentration ◽  
25 Hydroxyvitamin D ◽  
Serum Pth

AbstractSerum vitamin D (25-hydroxyvitamin D (25OHD)) may influence serum parathyroid hormone (PTH) levels and bone mineral density (BMD). In the present study, we assessed serum 25OHD concentration and its association with PTH and BMD in urban males from Guiyang (N26.57°), the capital city of Guizhou province, Southwest China. We recruited 634 males aged >20 years from the Guiyang Health Measures Survey, and stratified them into three groups according to age: young (20–39 years), middle aged (40–59 years) and older (60–79 years). We measured serum concentrations of 25OHD, PTH levels and BMD of the lumbar spine (L1–L4), femoral neck and total hip. In addition, we also explored the relationship between 25OHD and lifestyle, socio-economic characteristics and medical history by applying covariance analysis and locally weighted regression plots. The results showed that serum 25OHD was <50 nmol/l in 59·3 % of the subjects and >75 nmol/l in 12·6 % of the subjects. Higher level of serum PTH was detected in relation to lower concentrations of serum 25OHD up to 50 nmol/l. A negative correlation between serum 25OHD and PTH concentrations was observed (r −0·207, P=0·003). Mean concentration of serum PTH increased gradually and plateaued while concentrations of serum 25OHD decreased to 50 nmol/l. Gradual increase in serum PTH was observed as 25OHD concentration was <25 nmol/l (P=0·004). BMD values at all sites were greater in the higher serum 25OHD concentration group. This study shows that low concentrations of serum 25OHD were common in males, and bone health was likely to be improved when serum 25OHD values were between 30 and 50 nmol/l.

scholarly journals Vitamin D Deficiency and Insufficiency in Obese Children and Adolescents and Its Relationship with Insulin Resistance

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Emel Torun ◽  
Erdem Gönüllü ◽  
İlker Tolga Özgen ◽  
Ergül Cindemir ◽  
Faruk Öktem
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Obese Group ◽  
Control Group ◽  
Obese Children ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Obese Subjects

Objectives. We aimed to determine the relationship between insulin resistance and serum 25-hydroxyvitamin D (25-OHD) levels in obese children and their nonobese peers.Materials and Methods. Included in the study group were 188 obese children (aged 9–15 years), and 68 age- and gender-matched healthy children of normal weight as control group. Anthropomorphic data were collected on patients and fasting serum glucose, insulin, serum lipids, alanine aminotransaminase (ALT) and 25-OHD were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated in both groups.Results. The levels of 25-OHD in the obese group were significantly lower than those of the nonobese (). HOMA-IR, triglycerides, low-density lipoprotein, and ALT levels in the obese group were significantly higher than values of control group ( and , resp.). In the obese group, vitamin D deficiency, insufficiency, and sufficiency (25-OHD < 10 ng/dl, < 20, >10 ng/dl; > 20 ng/dl, resp.) were not correlated with HOMA-IR (, ). HOMA-IR was negatively correlated with BMI, BMI SDS, and BMI%, and triglycerides, low-density lipoprotein, and ALT levels ().Conclusion. The insulin resistance of the obese subjects who were vitamin D deficient and insufficient did not statistically differ from those with vitamin D sufficiency. Low 25-hydroxyvitamin D levels were not related with higher insulin resistance in obese children and adolescents. In obese subjects, insulin resistance was affected more from BMI, BMI SDS, and BMI% than from 25-hydroxyvitamin D levels.

scholarly journals The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

2019 ◽  
Author(s):  
Junzeng Si ◽  
kuibao li ◽  
peiyan shan ◽  
Junliang Yuan
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Small Vessel Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Small Vessel ◽  
Hydroxyvitamin D ◽  
Vessel Disease ◽  
25 Hydroxyvitamin D ◽  
Exact Relationship

Abstract Background: The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such association between 25(OH) D and SVD in China. Methods: We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25(OH) D: vitamin D deficiency (<12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (>20 ng/ml). Results: Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6±13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P=0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P<0.05). Logistic regression analysis revealed the level of 25(OH)D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P=0.001). Compared with the sufficient 25(OH)D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (Pinteraction=0.001). Conclusion: We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

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