1.
Study of Correlation of Serum Vitamin D Levels with Arterial Stiffness and Cardiovascular Morbidity in Elderly Individuals of Western Rajasthan.
Suthar, OP, Mathur, S, Gupta, V, Agarwal, H, Mathur, A, Singh, P, Sharma, SL
The Journal of the Association of Physicians of India. 2018;(3):18-21
Abstract
INTRODUCTION Vitamin D deficiency is highly prevalent condition in western countries as well as in India. Lower level of vitamin D is associated with increased arterial stiffness by activating renin-angiotensin-aldosterone system leading to increased cardiovascular morbidity and mortality including increased risk of coronary artery disease, stroke, peripheral vascular disease, hypertension, diabetes mellitus and metabolic syndrome. Our aim was to study the correlation between serum vitamin D level, various measures of arterial stiffness and cardiovascular morbidity in elderly individuals. MATERIAL AND METHOD The present study was conducted in collaboration with Department of Medicine, Department of Cardiology and Regional Geriatric Centre, NPHCE, MDM Hospital attached to Dr. S.N. medical college Jodhpur. Total 100 elderly individuals 60 yrs and above attending hospital for minor short illness, acute illness or for routine health checkup or with acute coronary events are included in the study. Vitamin D level was assessed by chemiluminescent immunoassay. Pulse Wave Velocity was determined by Periscope. RESULTS In subjects with coronary artery disease, 28.30% were vitamin D deficient, 49.05% were vitamin D insufficient and only 22.64% are vitamin D sufficient. In healthy subjects, 25.53% were vitamin D deficient, 23.40% were vitamin D insufficient and 51.04% were vitamin D sufficient. The difference between these groups was statistically highly significant. (p value-0.006). Various measures of arterial stiffness including Rt baPWV, Lt baPWV, cf PWV and pulse pressure are more in vitamin D deficient group as compared to vitamin D sufficient group. The difference was statistically significant. CONCLUSION Vitamin D deficiency is quite common condition in elderly individuals which besides its bone mineralization action is also involved in cardiovascular functions. Deficiency of vitamin D may cause increase in arterial stiffness and widening of pulse pressure which are the predictor of atherosclerosis and cardiovascular morbidity and mortality.
2.
The role of vitamin D, obesity and physical exercise in regulation of glycemia in Type 2 Diabetes Mellitus patients.
Bener, A, Al-Hamaq, AO, Kurtulus, EM, Abdullatef, WK, Zirie, M
Diabetes & metabolic syndrome. 2016;(4):198-204
Abstract
AIM: The aims of this study were to determine the role of vitamin D, obesity and physical exercise in the regulation of glycemia in Type 2 Diabetes Mellitus patients in a highly consanguineous population. DESIGN Case and control study. SETTING The survey was carried out at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar. SUBJECTS The study was conducted from November 2012 to June 2014 among subjects above 30 years of age. Of the 2224 registered with diagnosed diabetes and free diseases attending Hamad General Hospital and PHC centers agreed and gave their consent to study. METHODS Questionnaire included socio-demographic variables, body mass index (BMI), consanguinity, lifestyle habits, family history of diabetes, blood pressure and development of diabetes complications such as retinopathy, nephropathy, and neuropathy were collected at regular intervals throughout the follow-up. Univariate and multivariate statistical analysis were performed. RESULTS There were statistically significant difference between patients with diabetic and control in terms of ethnicity (p=0.012), level of education (p=0.002), occupation (p<0.001), monthly income (p<0.001), BMI(p=0.024), sport activity (p=0.018), cigarette smoking (p<0.001), consanguinity (p=0.029) and family history of Diabetes Mellitus (p<0.001) and co-morbidity hypertension (p=0.041). Further, the biochemistry values in the studied subjects with T2DM compared to healthy controls and the study revealed that serum Vitamin D, BMI, fasting glucose level, calcium, HbA1c, total cholesterol HDL, LDL, bilirubin, triglycerides, uric acid and blood pressure systolic and diastolic were higher in T2DM compared to their counterparts. Multivariate logistic regression showed that vitamin D deficiency ng/mL, Family History of T2DM, BMI (kg/m2) hypertension, consanguinity, income, mother occupation, ethnicity, educational level and Lack of physical exercise variables were significant predictors of diabetes. In the group of Diabetes Mellitus Type 2 patients, 39.3% as opposed to 51.2% in the control group had vitamin D deficiency, 25(OH) D3 levels≤10ng/ml (p<0.001). In the group of Diabetes Mellitus Type 2 patients, 34.6% as opposed to 37.9% in the control group had vitamin D insufficiency, 25(OH)D3 levels <20ng/ml (p < 0.001). In the group of Diabetes Mellitus Type 2 patients, 22.8% as opposed to 14.2% in the control group had vitamin D sufficiency, 25(OH)D3 levels >30 10ng/ml (p < 0.001). CONCLUSION Vitamin D, family history of diabetes, consanguinity marriages' and hereditary gene-environment interactions and physical exercise may also contribute to the current diabetes epidemic in Qatari's Arab populations.
3.
Assessment of 25-OH vitamin D levels and abnormal blood pressure response in female patients with cardiac syndrome X.
Babür Güler, G, Güler, E, Hatipoğlu, S, Güneş, HM, Geçmen, Ç, Demir, GG, Barutçu, İ
Anatolian journal of cardiology. 2016;(12):961-966
Abstract
OBJECTIVE Vitamin D deficiency is associated with coronary artery disease, hypertension, heart failure, endothelial dysfunction, and metabolic syndrome. The pathophysiology of cardiac syndrome X (CSX) involves many pathways that are influenced by vitamin D levels. This study aimed to investigate the relationship between vitamin D deficiency and abnormal blood pressure response to exercise in patients with CSX. METHODS This was a cross-sectional and observational study. Fifty females with normal epicardial coronary arteries who presented with typical symptoms of rest or effort angina and 41 healthy age-matched female controls, were included. Patients with cardiomyopathy, severe valvular disease, congenital heart disease, and left ventricular hypertrophy were excluded. All patients underwent stress electrocardiography examination and 25-hydroxy (OH) vitamin D level measurements. RESULTS Levels of 25-OH vitamin D were significantly lower in CSX patients (9.8±7.3 ng/mL vs. 18.1±7.9 ng/mL; p<0.001). Systolic blood pressure (SBP) (188±15 mm Hg vs. 179±17 mm Hg; p=0.013) and diastolic blood pressure (DBP) (98±9 mm Hg vs. 88±9 mm Hg; p<0.001) during peak exercise were higher in CSX patients. Levels of 25-OH vitamin D were negatively correlated with peak SBP (r=-0.310, p=0.004) and peak DBP (r=-0.535, p<0.001) during exercise. To discard the multicollinearity problem, two different models were used for multivariate analyses. In the first model, metabolic equivalents (METs) (p=0.003) and 25-OH vitamin D levels (p=0.001) were independent predictors. METs (p=0.007), 25-OH vitamin D levels (p=0.008), and peak DBP were determined as independent predictors in the second multivariate model. CONCLUSION In patients with CSX, 25-OH vitamin D levels were lower than those in controls; moreover, 25-OH vitamin D deficiency was also associated with higher levels of peak DBP during exercise.