Vitamin D Deficiency in Premenopause: Endothelial and Diastolic
Functions With Hyperparathyroidism
Abstract
Introduction: Vitamin D deficiency(VDD) is a common condition in all
ages worldwide, especially in winter, and causes several adverse
cardiovascular outcomes. Although there is conflicting information about
the causes of adverse cardiac events in VDD, the accepted leading cause
is a pathogenic relationship with hyperparathyroidism. Aim: We aim to
demonstrate hyperparathyroidism’s effects, if present, on endothelial
and diastolic functions using echocardiography, carotid, and brachial
tissue Doppler imaging (tDi) in premenopausal women with VDD independent
from confounding risk factors. Methods: Our study is a cross-sectional,
observational study investigating premenopausal women aged 18-50 who
applied to internal medicine department. The patients are divided into
two groups according to parathyroid hormone(PTH) levels (Normal PTH 41
patients, abnormal PTH 27 patients). Study groups are analyzed for basal
characteristics, standard echocardiographic evaluation, carotid, and
brachial artery tDi features. Results: There were no significant
differences in age, height, weight, body mass index(BMI), and blood
pressures between the groups (all p values>0.05). The rate
of severe VDD was 76%. In terms of diastolic parameters, prolongation
of A wave durations and decreased E/A ratio were observed in the
secondary hyperparathyroidism (p values 0.042 and 0.031, respectively).
Also, carotid IMT is significantly higher in secondary
hyperparathyroidism(p=0.034). Conclusion: Our study showed that high PTH
levels have adverse effects on diastolic(A wave, E/A ratio) and
endothelial functions(carotid IMT) in premenopausal women diagnosed with
VDD, even in the absence of other confounding risk factors. We can state
that our study’s findings will contribute to the literature and are
predictive for future studies.