Impact of Vitamin D Supplementation on Bone Mineral Density and All-Cause Mortality in Heart Transplant Patients

• Published in: Biomedicines 2021-10, Vol.9 (10), p.1450
• Main Authors: Abulmeaty, Mahmoud M. A., Almutawa, Deema A., Selimovic, Nedim, Almuammar, May, Al-Khureif, Abdulaziz A., Hashem, Mohamed I., Hassan, Heba M., Moety, Doaa A. Abdel
• Format: Article
• Language: English
• Subjects: all-cause mortality; Biochemistry & Molecular Biology; Body mass index; Bone density; Bone mineral density; calcitonin; calcitriol; Cardiac and Cardiovascular Systems; Cardiomyopathy; Creatinine; d deficiency; Dietary supplements; Dual energy X-ray absorptiometry; etidronate; Fractures; Heart failure; heart transplant; Heart transplantation; Heart transplants; hyperparathyroidism; Kardiologi; metabolism; Mortality; Nutrient deficiency; Osteoporosis; Pharmacology & Pharmacy; prevention; recipients; Research & Experimental Medicine; Sample size; society; supplementation; Supplements; Survival analysis; Vitamin D; Vitamin deficiency
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines9101450

Vitamin D (VD) deficiency is frequently reported in heart transplant (HT) recipients and routinely supplemented. However, the efficacy of VD supplementation on bone mineral density (BMD) and its association with all-cause mortality is underinvestigated. The VD levels and BMD were studied for two years, and the association of VD and BMD with all-cause mortality risk was investigated. Ninety-six HT patients (38.18 ± 12.10 years old; 74% men) were followed up during VD, Ca, and Mg supplementation. Anthropometric measurements, BMD by Dual-energy X-ray absorptiometry (DEXA) scan, VD concentrations, and related biochemical parameters were analyzed before, 1 year, and 2 years after HT. Despite significant improvement of VD3 and 25-hydroxy VD (25OHVD) levels especially in the men, BMD parameters were insignificantly changed. After 2 years, the all-cause mortality rate was 15.6%. High pretransplant levels of 25OHVD failed to improve the survival probability. Cox’s regression showed a 32.7% increased hazard ratio for each unit increase in body mass index (95% CI: 1.015–1.733, p = 0.038), in the VD-deficient group rather than in the VD-sufficient one. In conclusion, VD supplementation improves the biochemical status, especially in VD-deficient HT. However, its impact on the BMD and mortality was not as usually expected. Further investigation of the disturbed VD metabolism in HT is warranted.