Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients.
Mahmoud Mustafa Ali AbulmeatyDeema A AlmutawaNedim SelimovicMay AlmuammarAbdulaziz A Al-KhureifMohamed I HashemHeba M HassanDoaa A Abdel MoetyPublished in: Biomedicines (2021)
Vitamin D (VD) deficiency is frequently reported in heart transplant (HT) recipients and routinely supplemented. However, the efficacy of VD supplementation on bone mineral density (BMD) and its association with all-cause mortality is underinvestigated. The VD levels and BMD were studied for two years, and the association of VD and BMD with all-cause mortality risk was investigated. Ninety-six HT patients (38.18 ± 12.10 years old; 74% men) were followed up during VD, Ca, and Mg supplementation. Anthropometric measurements, BMD by Dual-energy X-ray absorptiometry (DEXA) scan, VD concentrations, and related biochemical parameters were analyzed before, 1 year, and 2 years after HT. Despite significant improvement of VD3 and 25-hydroxy VD (25OHVD) levels especially in the men, BMD parameters were insignificantly changed. After 2 years, the all-cause mortality rate was 15.6%. High pretransplant levels of 25OHVD failed to improve the survival probability. Cox's regression showed a 32.7% increased hazard ratio for each unit increase in body mass index (95% CI: 1.015-1.733, p = 0.038), in the VD-deficient group rather than in the VD-sufficient one. In conclusion, VD supplementation improves the biochemical status, especially in VD-deficient HT. However, its impact on the BMD and mortality was not as usually expected. Further investigation of the disturbed VD metabolism in HT is warranted.
Keyphrases
- bone mineral density
- dual energy
- postmenopausal women
- end stage renal disease
- body composition
- body mass index
- computed tomography
- chronic kidney disease
- newly diagnosed
- heart failure
- peritoneal dialysis
- prognostic factors
- atrial fibrillation
- magnetic resonance
- cardiovascular disease
- cardiovascular events
- mass spectrometry
- replacement therapy
- kidney transplantation