Serum vitamin D and parathyroid hormone in relation to cardiac structure and function: the ICELAND-MI substudy of AGES-Reykjavik
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Published on: December 9, 2015
A J van Ballegooijen1, M Visser, M F Cotch
1Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, 1081 HV Amsterdam, The Netherlands. hanne.van.ballegooijen@vu.nl
Insights
Higher parathyroid hormone (PTH) levels are linked to increased left ventricular mass and reduced heart function in older adults. Vitamin D levels showed no significant association with cardiac structure or function in this study.
Area of Science:
- Cardiology
- Endocrinology
- Geriatrics
Background:
- Emerging evidence suggests a link between vitamin D, parathyroid hormone (PTH), and cardiac disease development.
- This study explores the relationship between these biomarkers and cardiac health.
Purpose of the Study:
- To investigate the cross-sectional association between 25-hydroxyvitamin D (25OHD) and PTH concentrations with cardiac structure and function.
- Utilizing cardiac magnetic resonance imaging (MRI) to assess these relationships in an older population.
Main Methods:
- Analysis of the ICELAND-MI substudy cohort (n=969), part of the Age, Gene/Environment Susceptibility-Reykjavik Study.
- Measurements included serum 25OHD (n=992) and intact PTH (n=203) concentrations.
- Cardiac structure and function assessed via MRI in participants aged 76 ± 5.3 years, with 51% female.
Main Results:
- Serum 25OHD concentrations were not significantly associated with cardiac MRI measures after covariate adjustment.
- Higher PTH quartiles were significantly associated with greater left ventricular (LV) mass (7.3 g increase).
- Higher PTH quartiles were also associated with lower LV ejection fraction (5.1% decrease) in fully adjusted models.
Conclusions:
- Serum 25OHD levels do not appear to be associated with cardiac structure or function in this older white population.
- Elevated PTH concentrations are linked to adverse cardiac remodeling, including increased LV mass and reduced systolic function.
- PTH may play a role as a determinant in cardiac remodeling processes.
Context:
Emerging evidence suggests that vitamin D and PTH may play a role in the development of cardiac diseases.
Objective:
We investigated whether 25-hydroxyvitamin D (25OHD) and PTH concentrations are cross-sectionally associated with cardiac structure and function using magnetic resonance imaging (MRI).
Design, Setting, And Participants:
ICELAND-MI is a substudy of the Age, Gene/Environment Susceptibility-Reykjavik Study, an older-aged community-dwelling cohort with oversampling of participants with diabetes (29%) and measurements between 2004 and 2007. Serum 25OHD concentrations were measured using an immunoassay (n = 992). Intact PTH concentrations were measured using a 2-site immunoassay (n = 203). We included 969 participants for this cross-sectional analysis (mean age 76 ± 5.3 years, 51% female). Mean 25OHD was 54.2 ± 25.5 nmol/L and the median PTH was 4.5 pmol/L (range 1.5-18).
Main Outcomes:
MRI to measure cardiac structure and function was the main outcome.
Results:
The lowest 25OHD category (<25 nmol/L) compared with the highest category (≥75 nmol/L) was associated with a smaller left and right atrial area in unadjusted analyses; however, the associations became nonsignificant after adjustment for covariates. The highest PTH quartile compared with the lowest quartile was significantly associated with a 7.3 g (95% confidence interval 0.8, 13.8) greater left ventricular (LV) mass and a 5.1% (-9.1, -1.1) lower LV ejection fraction compared with the lowest PTH quartile in the fully adjusted model.
Conclusions:
Serum 25OHD concentrations were not associated with MRI measures in an older white population. Higher PTH concentrations were associated with greater LV mass and lower systolic function and may point to a potential role for PTH as a determinant of cardiac remodeling.
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