2026-06-27T10:23:32Zhttps://docta.ucm.es/rest/oai/request
oai:docta.ucm.es:20.500.14352/81992023-08-25T18:01:05Zcom_20.500.14352_14col_20.500.14352_15
Docta Complutense author Callejo Arranz, María author Mondejar Parreño, Gema author Esquivel Ruiz, Sergio Antonio author Olivencia Plaza, Miguel Ángel author Moreno Gutiérrez, Laura author Blanco, Isabel author Escribano Subías, María Pilar author Cogolludo Torralba, Ángel Luis author Barbera, Joan Albert author Pérez Vizcaíno, Francisco 2023-06-17T09:06:49Z 2023-06-17T09:06:49Z 2020-02-06 2077-0383 10.3390/jcm9020448 https://hdl.handle.net/20.500.14352/8199 https://doi.org/10.3390/jcm9020448 https://www.mdpi.com/2077-0383/9/2/448 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. eng Atribución 3.0 España Total, Bioavailable, and Free Vitamin D Levels and Their Prognostic Value in Pulmonary Arterial Hypertension journal article URL https://docta.ucm.es/bitstreams/37a06c99-2e75-450e-aeaa-9f5b1a1218bd/download File MD5 73f763a052f82e182f72dfb519fb1f90 2350226 application/pdf jcm-09-00448-v2.pdf