Parathyroid hormone response to vitamin D insufficiency in elderly males with chronic heart failure

• Published in: Physiological research Vol. 60 Suppl 1; pp. S155 - S163
• Main Authors: Bozic, B, Loncar, G, Prodanovic, N, Lepic, T, Radojicic, Z, Cvorovic, V, Dimkovic, S, Popovic, V
• Format: Journal Article
• Language: English
• Published: Czech Republic Institute of Physiology 01.01.2011
• Subjects: Absorptiometry, Photon; Adiponectin - blood; Age Factors; Aged; Analysis of Variance; Biomarkers - blood; Body Composition; Bone Density; Case-Control Studies; Chi-Square Distribution; Chronic Disease; Collagen - blood; Cross-Sectional Studies; Echocardiography, Doppler; Exercise Test; Heart failure; Heart Failure - blood; Heart Failure - complications; Heart Failure - diagnosis; Humans; Hyperparathyroidism, Secondary - blood; Hyperparathyroidism, Secondary - complications; Hyperparathyroidism, Secondary - diagnosis; Hypoparathyroidism - blood; Hypoparathyroidism - complications; Hypoparathyroidism - diagnosis; Logistic Models; Male; Middle Aged; Mortality; Odds Ratio; Older people; Parathyroid Hormone - blood; Peptide Fragments - blood; Prognosis; Risk Assessment; Risk Factors; Serbia; Severity of Illness Index; Stroke Volume; Surveys and Questionnaires; Ventricular Function, Left; Vitamin D; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; Vitamin D Deficiency - diagnosis; Serbia
• ISSN: 0862-8408; 1802-9973
• DOI: 10.33549/physiolres.932185

Secondary hyperparathyroidism (SHPT) may contribute to the systemic illness that accompanies chronic heart failure (CHF). Healthy elderly with vitamin D deficiency who did not develop hyperparathyroidism (functional hypoparathyroidism, FHPT) had lower mortality than those who did. This study was designed to examine determinants of the PTH response in the vitamin D insufficient CHF patients. Sixty five vitamin D insufficient males with NYHA class II and III and 20 control subjects age >/=55 years were recruited. Echocardiography, physical performance, NT-pro-BNP, PTH, 25-hydroxyvitamin D (25(OH)D), adiponectin and bone activity surrogate markers (OPG, RANKL, OC, beta-CTx) were assessed. Increased NYHA class was associated with SHPT, while physical performance was inferior compared to FHPT. SHPT was associated with lower left ventricular ejection fraction (LVEF) and flow mediated dilatation, but with higher left heart dimensions, left ventricular mass index and right ventricular systolic pressure. CHF patients with SHPT had increased NT-pro-BNP, adiponectin and bone markers, but decreased 25(OH)D compared to those with FHPT. Independent determinants for SHPT in CHF patients with vitamin D insufficiency were LVEF, adiponectin and beta-CTx, irrespective of renal function and serum vitamin D levels. In conclusion, increased PTH levels, but not low vitamin D, demonstrated close relation to CHF severity.