Association of the calcitriol to calcifediol ratio with cardiac involvement in newly diagnosed sarcoidosis

Elias Giallafos; Lykourgos Kolilekas; Effrosyni Manali; Spyros Katsanos; Paschalis Steiropoulos; Elias Tsougos; Grigorios Stratakos; Mina Gaga; Nikos Koulouris; Spyros Papiris; Ioannis Ilias

doi:10.36141/svdld.v37i3.9939

Association of the calcitriol to calcifediol ratio with cardiac involvement in newly diagnosed sarcoidosis

Authors

Elias Giallafos 1st Respiratory Medicine Department, Athens Chest Hospital ‘Sotiria’ Medical School, National and Kapodistrian University of Athens, Greece; 6th Department of Cardiology, Heart Failure and Preventive Cardiology Section, Ygeia Hospital, Athens, Greece; 7 Department of Diabetes, Endocrinology and Metabolism, Elena Venizelou Hospital, Athens, Greece
Lykourgos Kolilekas 7th Respiratory Medicine Department, Athens Chest Hospital ‘Sotiria’, Athens, Greece
Effrosyni Manali 2nd Pulmonary Medicine Department, General University Hospital ‘Attikon’, Medical School, National and Kapodistrian University of Athens, Greece
Spyros Katsanos 2nd Department of Cardiology, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Greece
Paschalis Steiropoulos Department of Respiratory Medicine, University General Hospital, Medical School, Democritus University of Thrace, Greece
Elias Tsougos 6th Department of Cardiology, Heart Failure and Preventive Cardiology Section, Ygeia Hospital, Athens, Greece
Grigorios Stratakos 1st Respiratory Medicine Department, Athens Chest Hospital ‘Sotiria’ Medical School, National and Kapodistrian University of Athens, Greece
Mina Gaga 7th Respiratory Medicine Department, Athens Chest Hospital ‘Sotiria’, Athens, Greece
Nikos Koulouris 1st Respiratory Medicine Department, Athens Chest Hospital ‘Sotiria’ Medical School, National and Kapodistrian University of Athens, Greece
Spyros Papiris 2nd Pulmonary Medicine Department, General University Hospital ‘Attikon’, Medical School, National and Kapodistrian University of Athens, Greece
Ioannis Ilias Department of Diabetes, Endocrinology and Metabolism, Elena Venizelou Hospital, Athens, Greece

Keywords:

Myocardial Sarcoidosis, Vit. D Metabolism

Abstract

Vitamin D (VitD) has been shown to influence many diseases, including sarcoidosis (Sa) and cardiovascular diseases with decreasing levels of vitamin being correlated with increased mortality. A possible association between VitD metabolites with cardiac involvement in patients with Sa which impairs prognosis, even with preserved left ventricular ejection fraction (EF) has not been seen.

Aim of this study was to evaluate serum 1,25(OH)2D3, 25(OH)D3 and their ratio (VDR) with myocardial involvement in Sa.

Methods-Results: 87 newly diagnosed sarcoidosis patients in two groups of cardiac (GroupB) and non-cardiac (Group A) involvement were studied for serum serum 25(OH)D3 and 1,25(OH)2D3 levels. Laboratory and clinical features including pulmonary and cardiac function parameters were collected. The 21 patients forming group B had significantly higher body mass index (BMI) (27.09±5.14vs30.06±4.63 p=0.013), lower EF (63.26±3.54vs60.9±4.36, p=0.009), higher 25(OH)D3 (19.44±9.99vs24.19±8.84, p=0.039) and lower VDR (1.6±0.84vs1.16±0.33, p=0.0001). Logistic regression was performed to ascertain the effects of BMI, EF, VDR on the likelihood that subjects had cardiac involvement. The logistic regression model was statistically significant (Chi square=21.257, p=0.0001). The obtained model correctly predicted 80.82% of cases. For each incremental increase in VDR or EF subjects were 5.55 or 1.22 times less likely to exhibit cardiac involvement, respectively, whereas for each incremental increase in BMI subjects were 0.78 times more likely to exhibit cardiac involvement.

Conclusion: The role of Vit D metabolites and especially VDR may represent a promising simple informative tool for initially assessing cardiac involvement in Sa; worth to be further evaluated in the future.