Format

Send to

Choose Destination
J Clin Endocrinol Metab. 2015 Jan;100(1):72-80. doi: 10.1210/jc.2014-3013.

25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and postoperative outcome in cardiac surgery.

Author information

1
Clinic for Thoracic and Cardiovascular Surgery (A.Z., J.B.E.,T.B., J.F.G., J.B.) and Institute for Laboratory and Transfusion Medicine (J.K., J.D., C.K.), Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany.

Abstract

CONTEXT:

Several cohort studies have reported U-shaped or inverse J-shaped associations between circulating 25-hydroxyvitamin D [25OHD] and clinical outcomes.

OBJECTIVE:

We aimed to investigate in cardiac surgical patients the association of preoperative 25OHD and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] levels with the risk of major adverse cardiac and cerebrovascular events (MACCE).

DESIGN:

A prospective cohort study of adult cardiac surgical patients in 2012-2013 was used.

SETTING:

The study was conducted at the Heart and Diabetes Center North Rhine-Westphalia, Germany.

PATIENTS:

A total of 3371 adult patients participated in the study.

INTERVENTION:

None Measurements: The main outcome measure was MACCE until discharge. We categorized vitamin D metabolite levels into subgroups and performed multivariable-adjusted logistic regression analysis to estimate odds ratios (ORs) of MACCE. Moreover, we performed multiple regression analysis to assess the association of 25OHD and circulating 1,25(OH)2D3 with preoperative parameters.

RESULTS:

As compared with patients in the 25OHD reference category (75-100 nmol/L), the multivariable-adjusted odds ratios (OR) of MACCE was significantly higher in patients with deficient 25OHD levels (< 30 nmol/L) (OR = 2.06 [95%CI: 1.24-3.43]), but was comparable in patients with 25OHD levels > 100 nmol/L (OR = 1.16 [95% CI: 0.56-2.37]). Poor kidney function was an important predictor of high 25OHD (>100 nmol/L) and low 1,25(OH)2D3 levels. 1,25(OH)2D3 was not independently associated with the incidence of MACCE.

CONCLUSIONS:

In cardiac surgical patients, deficient but not high 25OHD levels are independently associated with the risk of MACCE. Cohort studies should consider potential interrelationships between kidney function, circulating vitamin D metabolite levels, and clinical outcome.

PMID:
25365313
DOI:
10.1210/jc.2014-3013
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center