3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
Front Endocrinol (Lausanne). 2021 Aug 11;12:714728. doi: 10.3389/fendo.2021.714728. eCollection 2021.
Pancreas transplantation is a high-risk procedure in terms of cardiovascular complications. Therefore, identification of all cardiovascular risk factors is crucial to prevent cardiovascular complications after pancreas transplantation. Vitamin D deficiency (VDD) appears to be a potential risk factor for coronary artery disease.
To determine the prevalence of VDD in pancreas transplant candidates, and further to examine the relationship between vitamin D and the prevalence of coronary artery disease and lipid profile parameters.
This is a prospective cross-sectional study. We enrolled consecutive patients with type 1 diabetes eligible for simultaneous pancreas-kidney transplantation or pancreas transplant alone. The laboratory tests included HbA1c, lipid profile, creatinine, and total 25-hydroxyvitamin D (25(OH)D). The diagnosis of coronary artery disease was based on coronary angiography.
The study population included 48 patients. VDD was revealed in 48% of patients and coronary artery disease in 35% of patients. The mean concentration of vitamin D in the entire cohort was 21.3 ± 9.48 ng/ml. The median value of 25(OH)D in patients with coronary artery disease was significantly lower than in patients without coronary artery disease (18.5 (11.6-21.5) . 24.8 (18.4-31.8) ng/ml, p = 0.018). There was a significant relationship between VDD and coronary artery disease (OR = 4.36; 95% confidence interval (CI): 1.22-15.64, p = 0.034). A patient's odds of having coronary artery disease while having a sufficient level of vitamin D was 4.36 times lower than if the patient had VDD. There was a significant relationship between VDD and hypertension (OR = 5.91; 95% CI: 1.12-31.20, p = 0.039) and hemodialysis (OR = 4.25; 95% CI: 1.25-14.5, p = 0.023). There was no significant correlation between 25(OH)D and lipid profile.
VDD is highly prevalent in pancreas transplant candidates with type 1 diabetes. There is a significant relationship between VDD and increased prevalence of coronary disease. The lack of any significant association between serum vitamin D and lipid profile suggests that the relationship between vitamin D and coronary artery disease results from other causes.
胰腺移植在心血管并发症方面是一项高风险的手术。因此，识别所有心血管危险因素对于预防胰腺移植后的心血管并发症至关重要。维生素 D 缺乏症（VDD）似乎是冠心病的一个潜在危险因素。
确定胰腺移植候选者中 VDD 的患病率，并进一步研究维生素 D 与冠心病和血脂参数患病率之间的关系。
这是一项前瞻性的横断面研究。我们纳入了符合条件的 1 型糖尿病患者，这些患者适合同时进行胰腺-肾脏移植或单独进行胰腺移植。实验室检查包括糖化血红蛋白、血脂、肌酐和总 25-羟维生素 D（25（OH）D）。冠心病的诊断基于冠状动脉造影。
研究人群包括 48 例患者。48%的患者存在 VDD，35%的患者存在冠心病。整个队列的维生素 D 平均浓度为 21.3 ± 9.48ng/ml。冠心病患者的 25（OH）D 中位数明显低于无冠心病患者（18.5（11.6-21.5）. 24.8（18.4-31.8）ng/ml，p = 0.018）。VDD 与冠心病之间存在显著关系（OR = 4.36；95%置信区间（CI）：1.22-15.64，p = 0.034）。当患者的维生素 D 水平充足时，患冠心病的可能性是 VDD 患者的 4.36 倍。VDD 与高血压（OR = 5.91；95%CI：1.12-31.20，p = 0.039）和血液透析（OR = 4.25；95%CI：1.25-14.5，p = 0.023）之间存在显著关系。25（OH）D 与血脂谱之间无显著相关性。
1 型糖尿病的胰腺移植候选者中 VDD 非常普遍。VDD 与冠心病患病率增加之间存在显著关系。血清维生素 D 与血脂谱之间缺乏任何显著关联表明，维生素 D 与冠心病之间的关系源于其他原因。
