Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study.

Ufuk Turan Kursat Korkmaz,Kemalettin Erdem,Umut Esen,Ahmet Yuksel,Yusuf Velioglu,Suleyman Ersoy,Ayhan Cetinkaya,Erhan Renan Ucaroglu,Humeyra Celik,Deniz Demir

doi:10.1590/1516-3180.2020.0457.r1.04022021

Abstract

Vitamin D has relationships with pathogenesis and inflammation pathways in many diseases. Its deficiency may make clinicians think not only of supplementation but also of presence of other diseases. To investigate the relationship between vitamin D levels and deep vein thrombosis (DVT), given that reduced levels are related to increased risk of cardiovascular diseases. Case-control study conducted in the cardiovascular surgery and family medicine departments of a hospital in Turkey. A total of 280 participants were included: 140 each in the DVT and control groups. Basic clinical characteristics, comorbidities and serum 25-hydroxyvitamin D (25(OH)D) levels were recorded and then compared between the groups. Serum 25(OH)D levels were also evaluated separately in three subgroups (sufficient, insufficient and deficient). Serum 25(OH)D levels were significantly lower in the DVT group than in the controls (P < 0.001). Females in the DVT group had lower 25(OH)D levels than those in the control group (P = 0.002). Nonetheless, the median 25(OH)D level (16.41 ng/ml) of the control group was still below the reference value. Logistic regression analysis showed that 25(OH)D was a significant predictor of DVT. Weight, height and body mass index, which all presented interaction, were significant in the logistic regression analysis but not in individual analyses. The serum vitamin D levels of DVT patients were lower than those of controls. If the results obtained from our study are supported by further large-scale randomized controlled trials, vitamin D replacement may be brought into the agenda for protection against DVT.

Highlights

Vitamin D is a fat-soluble vitamin that is synthesized non-enzymatically in the skin and metabolized in the liver and kidneys
The study group consisted of 71 males and 69 females, while the control group consisted of 67 males and 73 females
Higher number of patients in the deep vein thrombosis group were found to have vitamin D deficiency, in comparison with the healthy participants, whereas the control group was found to have a greater number of participants with sufficient vitamin D (Tables 1 and 2) (P < 0.001)

Summary

INTRODUCTION

Vitamin D is a fat-soluble vitamin that is synthesized non-enzymatically in the skin and metabolized in the liver and kidneys. It arranges the immune response of the body, acts as a steroid hormone and plays a crucial role in mineral homeostasis and skeletal health.[1] Serum vitamin D levels in the range 30-60 ng/ml (75-150 nmol/l) are considered normal. It can lead to pulmonary thromboembolism, venous gangrene, chronic venous insufficiency and post-thrombotic syndrome.[11] The most well-known factors in the etiology of lower-extremity deep vein thrombosis are genetic predisposition, malignancy, history of surgical operation, immobilization, trauma, bone fractures, long journeys and oral contraceptive use.[12] there may be other factors that play a role in the etiopathogenesis of deep vein thrombosis

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