TY - JOUR
T1 - Hypovitaminosis D in African Americans residing in Memphis, Tennessee with and without heart failure
AU - Alsafwah, Shadwan
AU - Laguardia, Stephen P.
AU - Nelson, Maeda D.
AU - Battin, David L.
AU - Newman, Kevin P.
AU - Carbone, Laura D.
AU - Weber, Karl T.
PY - 2008/4
Y1 - 2008/4
N2 - BACKGROUND: Factors contributing to heart failure (HF) in African Americans (AA) are under investigation. Reduced 25(OH)D confers increased cardiovascular risk, including HF. METHODS: We monitored serum 25(OH)D, 1,25(OH)2D3, parathyroid hormone (PTH), and creatinine clearance in 102 AA residing in Memphis: 58 hospitalized with decompensated HF of ≥4 weeks in 34 (21 men; 53.3 ± 1.8 years) or of 1 to 2 weeks in 24 (17 men; 49.6 ± 2.4 years) and associated with a dilated cardiomyopathy and reduced ejection fraction (<35%); 19 outpatients with compensated HF (14 men; 52.6 ± 2.7 years) with comparable ejection fraction; 16 outpatients (9 men; 55.4 ± 2.9 years) with heart disease, but without HF; and 9 healthy volunteers (3 men; 35.8 ± 3.5 years). RESULTS: Serum 25(OH)D ≤30 ng/mL was found in 96% and 90% with protracted or short-term decompensated HF, where it was of moderate to marked severity (<20 ng/mL) in 83% and 76%, respectively. In patients with either compensated or no HF, 25(OH)D <30 ng/mL was found in 95% and 100%, respectively, and in 30% of volunteers. Normal serum 1,25(OH)2D3 did not differ between patients. Serum PTH >65 pg/mL was found in all AA with decompensated HF of ≥4 weeks (132.4 ± 12.0 pg/mL) and 67% with 1 to 2 weeks duration (82.3 ± 7.9 pg/mL), but only 11% with compensated HF (45.8 ± 6.1 pg/mL), 12% without HF (29.6 ± 5.4 pg/mL), and none of the volunteers (31.1 ± 3.9 pg/mL). Creatinine clearance did not differ between patient groups. CONCLUSIONS: Hypovitaminosis D is prevalent amongst AA residing in Memphis, with or without HF. Elevations in serum PTH in keeping with secondary hyperparathyroidism are only found in AA with decompensated HF, where hypovitaminosis D and other factors are contributory.
AB - BACKGROUND: Factors contributing to heart failure (HF) in African Americans (AA) are under investigation. Reduced 25(OH)D confers increased cardiovascular risk, including HF. METHODS: We monitored serum 25(OH)D, 1,25(OH)2D3, parathyroid hormone (PTH), and creatinine clearance in 102 AA residing in Memphis: 58 hospitalized with decompensated HF of ≥4 weeks in 34 (21 men; 53.3 ± 1.8 years) or of 1 to 2 weeks in 24 (17 men; 49.6 ± 2.4 years) and associated with a dilated cardiomyopathy and reduced ejection fraction (<35%); 19 outpatients with compensated HF (14 men; 52.6 ± 2.7 years) with comparable ejection fraction; 16 outpatients (9 men; 55.4 ± 2.9 years) with heart disease, but without HF; and 9 healthy volunteers (3 men; 35.8 ± 3.5 years). RESULTS: Serum 25(OH)D ≤30 ng/mL was found in 96% and 90% with protracted or short-term decompensated HF, where it was of moderate to marked severity (<20 ng/mL) in 83% and 76%, respectively. In patients with either compensated or no HF, 25(OH)D <30 ng/mL was found in 95% and 100%, respectively, and in 30% of volunteers. Normal serum 1,25(OH)2D3 did not differ between patients. Serum PTH >65 pg/mL was found in all AA with decompensated HF of ≥4 weeks (132.4 ± 12.0 pg/mL) and 67% with 1 to 2 weeks duration (82.3 ± 7.9 pg/mL), but only 11% with compensated HF (45.8 ± 6.1 pg/mL), 12% without HF (29.6 ± 5.4 pg/mL), and none of the volunteers (31.1 ± 3.9 pg/mL). Creatinine clearance did not differ between patient groups. CONCLUSIONS: Hypovitaminosis D is prevalent amongst AA residing in Memphis, with or without HF. Elevations in serum PTH in keeping with secondary hyperparathyroidism are only found in AA with decompensated HF, where hypovitaminosis D and other factors are contributory.
KW - African Americans
KW - Heart failure
KW - Hypovitaminosis D
KW - Secondary hyperparathyroidism
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U2 - 10.1097/MAJ.0b013e318167b0bd
DO - 10.1097/MAJ.0b013e318167b0bd
M3 - Article
C2 - 18414068
AN - SCOPUS:42249096320
SN - 0002-9629
VL - 335
SP - 292
EP - 297
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 4
ER -