Effects of vitamin D level and oxidant-antioxidant balance on postoperative morbidity in diabetic and non-diabetic patients undergoing off-pump bypass surgery

Abstract

Objective: Atherosclerosis is still a major problem that cannot be resolved despite significant developments in cardiology and is the leading cause of death over worldwide. Endothelial dysfunction is triggered by multifactorial causes of oxidative stress in the cellular dimension and is associated with atherosclerosis. Despite the associated mechanisms are still unclear vitamin D deficiency is considered as one of the causing factors. Patient-method: In our study; randomized 100 consecutive patients with advanced atherosclerotic heart disease were classified as Group A (<20 ng /dl), Group B (21-29 ng /dl) and Group C (≥30 ng /dl) according to the vitamin D levels. They were underwent off-pump coronary artery bypass grafting. Clinical data of all cases, oxidant/antioxidant balance and thiol / disulfide levels were collected also. Results: Preoperative CRP and procalcitonin levels were significantly high in Group A (p=0.028 and p=0.031) according to the other vitamin D levels. There was no statistically significant difference (p=0.46) between all groups in terms of total antioxidant status (mmol /L). In the vitamin D deficient group (<20 ng /ml), oxidant /antioxidant index (OSI) was significantly high (p=0.0378). There was no significant difference between total and native thiol levels and disulfide / thiol contents. While the duration of intubation periods were similar (p=0.056), intensive care and hospital stay times were significantly higher in the Group A with diabetics, respectively; p=0.0034, p=0.00021. There was no significant difference between the other groups. This suggests that the inflammatory process, and oxidative stress one of the basic mechanisms of atherosclerosis, may be more severe in the vitamin D deficient group, especially in diabetics.Our results confirm vitamin D, antioxidant and anti-inflammatory activity.