RT Journal Article
T1 Total, Bioavailable, and Free Vitamin D Levels and Their Prognostic Value in Pulmonary Arterial Hypertension
A1 Callejo Arranz, María
A1 Mondejar Parreño, Gema
A1 Esquivel Ruiz, Sergio Antonio
A1 Olivencia Plaza, Miguel Ángel
A1 Moreno Gutiérrez, Laura
A1 Blanco, Isabel
A1 Escribano Subías, María Pilar
A1 Cogolludo Torralba, Ángel Luis
A1 Barbera, Joan Albert
A1 Pérez Vizcaíno, Francisco
AB Introduction: Epidemiological studies suggest a relationship between vitamin D deficiency and cardiovascular and respiratory diseases. However, whether total, bioavailable, and/or free vitamin D levels have a prognostic role in pulmonary arterial hypertension (PAH) is unknown. We aimed to determine total, bioavailable, and free 25-hydroxy-vitamin D (25(OH)vitD) plasma levels and their prognostic value in PAH patients. Methods: In total, 67 samples of plasma from Spanish patients with idiopathic, heritable, or drug-induced PAH were obtained from the Spanish PH Biobank and compared to a cohort of 100 healthy subjects. Clinical parameters were obtained from the Spanish Registry of PAH (REHAP). Results: Seventy percent of PAH patients had severe vitamin D deficiency (total 25(OH)vitD < 10 ng/mL) and secondary hyperparathyroidism. PAH patients with total 25(OH)vitD plasma above the median of this cohort (7.17 ng/mL) had better functional class and higher 6-min walking distance and TAPSE (tricuspid annular plane systolic excursion). The main outcome measure of survival was significantly increased in these patients (age-adjusted hazard ratio: 5.40 (95% confidence interval: 2.88 to 10.12)). Vitamin D-binding protein (DBP) and albumin plasma levels were downregulated in PAH. Bioavailable 25(OH)vitD was decreased in PAH patients compared to the control cohort. Lower levels of bioavailable 25(OH)vitD (<0.91 ng/mL) were associated with more advanced functional class, lower exercise capacity, and higher risk of mortality. Free 25(OH)vitD did not change in PAH; however, lower free 25(OH)vitD (<1.53 pg/mL) values were also associated with high risk of mortality. Conclusions: Vitamin D deficiency is highly prevalent in PAH, and low levels of total 25(OH)vitD were associated with poor prognosis.
PB MDPI
SN 2077-0383
YR 2020
FD 2020-02-06
LK https://hdl.handle.net/20.500.14352/8199
UL https://hdl.handle.net/20.500.14352/8199
LA eng
NO Ministerio de Economía y Competitividad (MINECO)/FEDER
DS Docta Complutense
RD 18 abr 2025