Purpose
Decreased vitamin D (VitD) levels stimulate the expression of the transmembrane L-type voltage-dependent calcium channels (LVDCC), which, in addition to calcium, absorb iron [1]. However, there is little and controversial data on the correlation of VitD levels with cardiac iron [2,3].
We investigated the association between vitamin D levels and cardiac iron and function in thalassemia major (TM) patients.
Methods and materials
We considered 278 TM patients (39.04±8.58 years, 56.8% females), consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network.
Myocardial iron overload (MIO) was quantified using a T2* segmental approach [4]. Left ventricular (LV) function parameters were quantified by cine images [5].
Measurement of serum 25(OH)D was carried out using a chemiluminescent immunoassay.
Results
Vitamin D supplements were taken by 61.4% of our patients. VitD levels were deficient (<20 ng/dl) in 107 (38.5%) patients, insufficient (20–30 ng/dl) in 96 (34.5%) patients and adequate (>30 ng/dl) in 75 (27.0%) patients. Patients with deficient vitD levels were significantly younger than patients with adequate (36.96±7.64 yrs vs 41.26±8.19 yrs; P<0.0001) as well as insufficient vitD levels (36.96±7.64 yrs vs 39.63±9.39 yrs; P=0.042) while no difference was detected in male to female ratio.
MIO (global heart T2*<20 ms) was significantly more frequent in...
Conclusion
In thalassemia major vitamin D deficiency is associated with and increased risk of cardiac iron overload. Periodic and regular assessment of VitD levels can be useful in the prevention not only of bone disorders but also of cardiac iron accumulation and subsequent overt dysfunction.
Personal information and conflict of interest
A. Meloni:
Nothing to disclose
L. Pistoia:
Nothing to disclose
C. Vassalle:
Nothing to disclose
S. Maffei:
Nothing to disclose
C. Bosi:
Nothing to disclose
F. Massei:
Nothing to disclose
V. Carrai:
Nothing to disclose
V. Positano:
Nothing to disclose
F. Cademartiri:
Nothing to disclose
References
1 Oudit GY, Sun H, Trivieri MG et al (2003) L-type Ca2+ channels provide a major pathway for iron entry into cardiomyocytes in iron-overload cardiomyopathy. Nat Med 9:1187-1194
2 Wood JC, Claster S, Carson S et al (2008) Vitamin D deficiency, cardiac iron and cardiac function in thalassaemia major. Br J Haematol 141:891-894
3 Shaykhbaygloo R, Moradabadi A, Taherahmadi H, Rafiei M, Lotfi F, Eghbali A (2020) Correlation of Cardiac and Liver Iron Level with T2*MRI and Vitamin D3 Serum Level in Patients with Thalassemia...