Vitamin D measurement and effect on outcome in a cohort of patients with heart failure. Issue 9 (September 2018)

• Record Type: Journal Article
• Authors: Saponaro, Federica; Saba, Alessandro; Frascarelli, Sabina; Prontera, Concetta; Clerico, Aldo; Scalese, Marco; Sessa, Maria Rita; Cetani, Filomena; Borsari, Simona; Pardi, Elena; Marvelli, Antonella; Marcocci, Claudio; Passino, Claudio; Zucchi, Riccardo
• Is Part Of: Endocrine connections. Volume 7:Issue 9(2018)
• Page Start: 957
• Page End: 964
• Publication Date: 2018-09
• Subjects: vitamin D -- 25-hydroxyvitamin D -- mass spectrometry coupled to high performances liquid chromatography -- immunoassay -- hypovitaminosis D; Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EC-18-0207
• Languages: English
• ISSNs: 2049-3614

Abstract

Abstract : Objectives: The aims of this paper were to evaluate the levels of Vitamin D (VitD) in patients with heart failure (HF), compared to a control group, to assess the effects of VitD on HF outcome and to compare VitD measurement between LIAISON immunoassay and HPLC-MS-MS methods in this population. Design and Methods: We collected clinical, biochemical and outcome data from 247 patients with HF and in a subgroup of 151 patients, we measured VitD both with LIAISON and HPLC-MS-MS. Results: HF patients had statistically lower 25OHD levels (45.2 ± 23.7 nmol/L vs 58.2 ± 24.0 nmol/L, P < 0.001) and a statistically higher prevalence of VitD insufficiency (61.1% vs 39.5%, P < 0.001) and deficiency (24.7% vs 6.6%, P < 0.001), compared to healthy controls. There was a significant inverse relationship between baseline 25OHD and risk of HF-related death, with a HR of 0.59 (95% CI 0.37–0.92, P = 0.02), confirmed in a multivariate adjusted analysis. Kaplan–Meier survival analyses showed that VitD insufficiency was associated with reduced survival in HF patients (log rank P = 0.017). There was a good agreement between LIAISON and HPLC-MS-MS (Cohen's kappa coefficient 0.70), but the prevalence of VitD insufficiency was significantly higher with the former compared to the latter method (58.3%, n = 88 vs 55.6%, n = 84, P < 0.001). LIAISON underestimated the 25OHD levels and showed a mean relative bias of −0.739% with 95% of limits of agreement (−9.00 to +7.52%), when compared to HPLC-MS-MS. Conclusions: 25OHD levels adequately measured by HPLC-MS-MS showed to be low in HF population and to be correlated with HF-related risk of death.