Abstract
Vitamin D deficiency is linked to cardiac dysfunction, vascular remodeling, metabolic syndrome and insulin resistance (IR). The aim of the present study was to evaluate the association between vitamin D levels and cardiovascular (CV) organ damage in a large cohort of newly diagnosed treatment-naïve hypertensive patients, and the role of IR in this context. We enrolled 500 Caucasian individuals, without CV or renal complications. Subjects underwent a complete evaluation and measurements of vitamin D, standard laboratory determinations and instrumental examination, including echocardiography and applanation tonometry. Linear regression analyses were performed to assess the correlation between pulse wave velocity (PWV) and left ventricular mass index (LVMI) with different covariates. PWV was significantly correlated with age (p < 0.0001), LDL cholesterol (p < 0.0001), BMI (p = 0.001), pulse pressure (PP) (p = 0.005) and high sensitivity C-reactive protein (hs-CRP) (p = 0.006), while an inverse correlation was observed with vitamin D levels (p < 0.0001), Matsuda index (p < 0.0001) and estimated glomerular filtration ratio (e-GFR) (p = 0.006). LVMI significantly correlated with PP (p < 0.0001), hs-CRP (p < 0, 0001) and age (p = 0.001), while an inverse relationship was observed with vitamin D levels (p < 0.0001), Matsuda’s insulin sensitivity index (ISI) (p < 0.0001) and e-GFR (p < 0.0001). Vitamin D was the strongest predictor of PWV and LVMI, explaining, respectively, 28.3% and 19.1% of their variation. Our study suggests that low vitamin D might be a biomarker of end-organ damage.
Highlights
Vitamin D exists in two forms: vitamin D2 and vitamin D3 [1]
Other exclusion criteria were history or clinical evidence of coronary and/or valvular disease, congestive heart failure, hyperlipidemia, peripheral vascular disease, chronic gastrointestinal diseases associated with malabsorption, chronic pancreatitis, positive history of any malignant disease, history of alcohol or drug abuse, hepatic or renal insufficiency, treatment with drugs that interfere with glucose metabolism or diagnosis of diabetes mellitus
There were no significant differences between groups for gender, Systolic blood pressure (SBP), DPB, pulse pressure (PP) and lowdensity lipoprotein (LDL) cholesterol, hs-PCR, levels of calcium and phosphorus and prevalence of smokers
Summary
Vitamin D exists in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) [1]. Vitamin D3 is present in a biologically inactive form and, due to hydroxylation reactions in liver and kidney, is transformed into the active form 1,25(OH) vitamin D, calcitriol [2]. Vitamin D receptors (VDRs) are present in different body tissues, including adipose, breast, smooth muscle, heart muscle and organs such as the pancreas. 1,25(OH)2D has autocrine and paracrine effects, and 25-hydroxyvitamin D represents the stable circulating form of vitamin D. The distribution of VDRs and the enzymatic system for metabolization of vitamin D in the cardiovascular (CV) site, led us to hypothesize cardioprotective, anti-inflammatory and antiatherosclerotic actions directly exerted by this vitamin
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