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

• Published in: The American journal of cardiology Vol. 111; no. 3; pp. 418 - 424
• Main Authors: van Ballegooijen, Adriana J., MSc, Visser, Marjolein, PhD, Kestenbaum, Bryan, MD, MS, Siscovick, David S., MD, MPH, de Boer, Ian H., MD, MS, Gottdiener, John S., MD, deFilippi, Christopher R., MD, Brouwer, Ingeborg A., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2013; Elsevier Limited
• Subjects: Adult; Aged; Biomarkers; Biomarkers - blood; Blood pressure; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Confidence intervals; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Heart attacks; Heart failure; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Incidence; Male; Mass Spectrometry; Methods; Middle Aged; Nutrition research; Parathyroid Hormone - blood; Prospective Studies; Studies; United States - epidemiology; Vitamin D; Vitamin D - blood; Vitamin deficiency; California
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.10.021

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.