Associations between vitamin D status, VDR gene polymorphisms and echocardiographic markers in Polish patients with cardiovascular disease

Abstract

Aim: This work was designed to investigate the associations between vitamin D metabolites, VDR gene polymorphisms and echocardiographic markers in a population of patients with cardiovascular disease. Methods: Echocardiographic markers for 42 patients were determined with tissue Doppler techniques. PCR-restriction fragment length polymorphism analysis identified genetic variants ApaI, TaqI, BsmI and FokI. A validated UHPLC-MS/MS method determined vitamin D metabolites. Results: Patients with the ApaI-GT genotype exhibited a lower pressure gradient across the aortic valve than ApaI-TT carriers. BMI, ApaI-GT, TaqI-TC, aortic arch diameter and maximal pressure gradient were significant univariate predictors of hypertension. Conclusion: A potential link exists between VDR gene polymorphisms and cardiovascular function.

Plain language summary

Vitamin D levels in the body and variations in the vitamin D receptor gene are linked to specific heart-related markers in Polish patients with heart conditions.

What is this article about?

Coronary artery disease is a global health issue and the third leading cause of death. While many factors are understood to contribute to coronary artery disease, there is ongoing debate about whether vitamin D deficiency is one of them. In the past 10 years, there has been extensive research on vitamin D deficiency, characterizing it as a kind of ‘pandemic’ affecting a large portion of the population. Vitamin D deficiency is associated with more severe cardiovascular health issues and a higher risk of mortality.

Why did we conduct this study?

This study was designed to assess how different forms of vitamin D (created in the body) and genetic differences relate to heart health in people with cardiovascular disease and how they might be linked to markers observed in heart imaging.

What were the results & what do they mean?

Some genes seem to be more protective against hypertension than others. Some forms of vitamin D and genetic differences were linked to changes in markers observed in heart imaging. Adult patients should consume around 1000 to 2000 IU of vitamin D per day to contribute to better overall heart health.

Tweetable abstract

A potential link exists between VDR gene polymorphisms and cardiovascular function.

Summary points

• This work was designed to evaluate the associations between 25-hydroxyvitamin D and 3-epi-25-hydroxyvitamin D₃, VDR gene polymorphisms and echocardiographic markers in Polish patients with cardiovascular disease.

• Higher age was positively correlated with late mitral diastolic flow velocity and was negatively correlated with pulmonary acceleration time.

• BMI was positively correlated with higher values of the right ventricle (RV), left ventricle (LV), left atrium, isovolumic relaxation time and maximal pressure gradient (MaxPG).

• Male sex was positively correlated with elevated RV, LV and aortic arch (AA).

• The metabolite 3-epi-25(OH)D₃ was negatively associated with RV, aortic valve, AA and deceleration time of the E wave, while 25(OH)D₂ was negatively associated with diastolic flow velocity.

• There were no significant differences in echocardiographic markers between patients whose 25(OH)D₃ levels were higher than or equal to 20 ng/ml and those below 20 ng/ml.

• Patients with the ApaI GT genotype had lower MaxPG than those with the ApaI TT genotype (4.71 [4.25–7.97] mmHg vs 8.56 [6.54–26.03] mm Hg; P_trend = 0.012).

• For each unit increase in BMI, the odds of developing hypertension are 1.5-times higher. The ApaI GT and TaqI TC genotypes had lower odds, 0.17 and 0.27, respectively.

• AA diameter and MaxPG were positively correlated with hypertension (odds ratio: 1.319; 95% CI: 1.031–1.031; p = 0.028 and odds ratio: 1.947; 95% CI: 1.048–3.616; p = 0.035, respectively).

• Particular ApaI genotypes can contribute to cardiovascular function. More extensive studies are required to confirm these findings.

Keywords: :

• 25-hydroxyvitamin D
• 3-epi-hydroxyvitamin D
• cardiovascular disease
• hypertension
• vitamin D receptor

Author contributions

M Abouzid: data curation, formal analysis, investigation, validation, visualization and original draft preparation; P Burchardt: data curation, investigation and resources; L Kagan: writing, reviewing and editing; F Główka: resources, writing, reviewing and editing; M Karaźniewicz-Łada: conceptualization, funding acquisition, project administration, resources, supervision, writing, reviewing and editing.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

Written consent was obtained from the included patients; the study was conducted according to the guidelines of the Declaration of Helsinki. Ethical approval was granted by the Bioethics Committee of Poznan University of Medical Sciences (protocol no. 273/15, date of approval: 5 March 2015; protocol no. 58/20, date of approval: 16 January 2020).

Acknowledgments

M Abouzid is a participant in the STER Internationalisation of Doctoral Schools Programme from NAWA Polish National Agency for Academic Exchange No. PPI/STE/2020/1/00014/DEC/02.