The Role of Parathyroid Hormone and Vitamin D Serum Concentrations in Patients with Cardiovascular Diseases

Abstract

25-hydroxyvitamin D (25(OH)D) plays a crucial role in human homeostasis. Its deficiency (vitamin D deficiency-VDD), being common in European population, combined with elevated concentration of parathyroid hormone (PTH), represents a vicious cycle of mechanisms leading to heart failure (HF). Despite several papers published in that field, the effect of VDD and PTH concentration on cardiovascular system remains unequivocal; thus, the aim of the study was to compare these data among HF and non-HF patients being prospectively enrolled into the study during hospital stay in the cardiology ward. Patients with HF had higher PTH concentration (85.0 ± 52.6 versus 64.5 ± 31.7, p ≤ 0.02) compared to non-HF patients. Mean PTH values were associated with the clinical status expressed by the New York Heart Association class (NYHA class) ("0"-66.04, "I"-56.57, "II"-72.30, "III"-85.59, and "IV"-144.37 pg/ml, p ≤ 0.00004). Interestingly, neither 25(OH)D (31.5 versus 29.7 ng/ml, p ≤ ns) nor phosphorus (P) (1.23 versus 1.18 mmol/l, p ≤ ns) nor total calcium (Ca²⁺) concentration (2.33 versus 2.37 mmol/l, p ≤ ns) differed among the groups. Reassuming PTH serum concentration in contrary to 25(OH)D, P and Ca²⁺ are significantly raised among the patients with HF and shows significant relationship with the clinical status expressed by the NYHA class.

Figure 1

Subgroups of patients. HF: heart failure; No HF: heart failure absent; CAD: coronary artery disease present; No CAD: coronary artery disease absent.

Figure 2

Incidence of HF divided according to tertiles of PTH serum concentration. HF: heart failure; PTH: parathyroid hormone; T: tertile.

Figure 3

Mean plot of PTH grouped by NYHA class. NYHA: New York Heart Association; PTH: parathyroid hormone.