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Journal

Relation of Vitamin D and Parathyroid Hormone to Cardiac Biomarkers and to Left Ventricular Mass (from the Cardiovascular Health Study)

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Published:25th Mar 2020
Vitamin D and parathyroid hormone (PTH) may affect cardiovascular health in patients with kidney disease and in the general population. The aim of this study was to investigate associations of serum 25-hydroxyvitamin D (25(OH)D) and PTH concentrations with�a comprehensive set of biochemical, electrocardiographic, and echocardiographic measurements of cardiac structure and function in the Cardiovascular Health Study. A total of 2,312 subjects who were free of cardiovascular disease at baseline were studied. Serum 25(OH)D and intact PTH concentrations were measured using mass spectrometry and a 2-site immunoassay. Outcomes were N-terminal pro-B-type natriuretic peptide, cardiac troponin T, electrocardiographic measures of conduction, and echocardiographic measures of left ventricular mass and diastolic dysfunction. At baseline, subjects had a mean age of 73.9 � 4.9�years, 69.7% were women, and 21% had chronic kidney disease (glomerular filtration rate�<60 ml min). mean 25(oh)d was 25.2 � 10.2 ng ml, and median pth was 51 pg ml (range 39 to 65). after adjustment, 25(oh)d was not associated with any of the biochemical, conduction, or echocardiographic outcomes. serum pth levels ?65 pg ml were associated with greater n-terminal pro-b-type natriuretic peptide, cardiac troponin t, and left ventricular mass in patients with chronic kidney disease. the regression coefficients were: 120 pg ml (95% confidence interval 36.1 to 204), 5.2 pg ml (95% confidence interval 3.0 to 7.4), and 17 g (95% confidence interval 6.2 to 27.8) (p><0.001). in subjects with normal kidney function, pth was not associated with the outcomes. in conclusion, in older adults with chronic kidney disease, pth excess is associated with higher n-terminal pro-b-type natriuretic peptide, cardiac troponin t, and left ventricular mass. these findings suggest a role for pth in cardiovascular health and the prevention of cardiac diseases.>

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