Vitamin D deficiency, cardiac iron and cardiac function in thalassaemia major
John C Wood1, Susan Claster, Susan Carson
1Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA. jwood@chla.usc.edu
Insights
Vitamin D deficiency is common in thalassemia major patients and linked to increased cardiac iron and reduced heart function. Monitoring vitamin D levels may help manage cardiac complications in these patients.
Area of Science:
- Endocrinology
- Cardiology
- Hematology
Background:
- Thalassemia major patients often experience iron overload due to frequent blood transfusions.
- Cardiac complications, including iron-induced cardiomyopathy, are a major cause of mortality in thalassemia major.
- The role of vitamin D in the cardiac health of thalassemia major patients is not well understood.
Purpose of the Study:
- To investigate the relationship between vitamin D levels (25-hydroxyvitamin D and 1,25-dihydroxyvitamin D) and cardiac parameters in patients with thalassemia major.
- To explore the association of vitamin D levels with age, liver iron, and ferritin in this patient group.
Main Methods:
- A cross-sectional study involving 24 patients with thalassemia major.
- Measurement of serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels.
- Assessment of cardiac function using left ventricular ejection fraction (LVEF) and cardiac iron load via R2* (1/T2*) magnetic resonance imaging.
- Correlation analysis between vitamin D metabolites, cardiac parameters, age, ferritin, and liver iron.
Main Results:
- Reduced 25-hydroxyvitamin D levels were observed in 13 out of 24 patients.
- 1,25-dihydroxyvitamin D levels were frequently elevated.
- 25-hydroxyvitamin D levels showed an inverse correlation with age (r² = 0.48) and liver iron (r² = 0.20).
- The ratio of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D was inversely related to cardiac R2* (r² = 0.42) and proportional to LVEF (r² = 0.49).
Conclusions:
- Vitamin D deficiency is prevalent in thalassemia major patients.
- The ratio of vitamin D metabolites is associated with cardiac iron levels and left ventricular ejection fraction.
- Vitamin D status may play a role in the development of cardiac complications in thalassemia major, suggesting potential therapeutic implications.
Abstract:
Vitamin D25-OH and D1-25OH levels were compared with cardiac R2* (1/T2*), left ventricular ejection fraction (LVEF), age, ferritin and liver iron in 24 thalassaemia major patients. Vitamin D25-OH levels were reduced in 13/24 patients while vitamin D1-25OH levels were often elevated. Vitamin D25-OH levels decreased with age (r(2) = 0.48) and with liver iron (r(2) = 0.20). Cardiac R2* was inversely related with the ratio of D25-OH to D1-25OH levels (r(2) = 0.42). LVEF was also proportional to the D25-OH/D1-25OH ratio (r(2) = 0.49). Vitamin D deficiency may be associated with cardiac iron uptake and ventricular dysfunction in thalassaemia major patients.
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