Universität zu Köln

Holler, Finn, Hannes, Tobias ORCID: 0000-0002-8550-2282, Germund, Ingo, Emmel, Mathias, Hoyer-Kuhn, Heike, Khalil, Markus, Sreeram, Narayanswami and ten Cate, Floris E. A. Udink (2016). Low serum 25-hydroxyvitamin D levels and secondary hyperparathyroidism in Fontan patients. Cardiol. Young, 26 (5). S. 876 - 885. CAMBRIDGE: CAMBRIDGE UNIV PRESS. ISSN 1467-1107

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Abstract

Background Limited data exist on the vitamin D status in Fontan patients. We determined the prevalence and potential risk factors of vitamin D deficiency in this patient subset. Methods and results Data were collected from 27 Fontan patients (55.6% male, mean age 8.15.3 years). Protein-losing enteropathy was diagnosed in six patients (22.2%). Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level of <20 ng/ml. The neutrophil-to-lymphocyte ratio, a marker of systemic inflammation, was calculated. Associations between laboratory measurements and patient characteristics were explored. Mean serum 25-hydroxyvitamin D level was 14.1 +/- 10.4 ng/ml. Vitamin D deficiency was found in 19/27 patients (70.3%). Only skin type was associated with vitamin D deficiency (p=0.04). Hyperparathyroidism was present in 5/21 (23.8%) patients, and was more prevalent in patients with protein-losing enteropathy (p<0.001). Parathyroid hormone levels correlated with parameters of systemic inflammation (neutrophil-to-lymphocyte ratio: r=0.484, p=0.026; relative lymphocyte count: r=-0.635, p=0.002). Vitamin D supplementation significantly increased serum 25-hydroxyvitamin D levels (p<0.0001), and was accompanied by a reduction in parathyroid hormone concentrations (p=0.032). Conclusions A high prevalence of vitamin D deficiency was found among Fontan patients, independent of age, time after Fontan procedure, ventricular morphology, and presence of protein-losing enteropathy. A potentially important link between parathyroid hormone levels and systemic inflammation is suggested.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Holler, Finn UNSPECIFIED UNSPECIFIED UNSPECIFIED Hannes, Tobias UNSPECIFIED orcid.org/0000-0002-8550-2282 UNSPECIFIED Germund, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Emmel, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoyer-Kuhn, Heike UNSPECIFIED UNSPECIFIED UNSPECIFIED Khalil, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Sreeram, Narayanswami UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Cate, Floris E. A. Udink UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-273790
DOI:	10.1017/S1047951115001444
Journal or Publication Title:	Cardiol. Young
Volume:	26
Number:	5
Page Range:	S. 876 - 885
Date:	2016
Publisher:	CAMBRIDGE UNIV PRESS
Place of Publication:	CAMBRIDGE
ISSN:	1467-1107
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROTEIN-LOSING ENTEROPATHY; VITAMIN-D DEFICIENCY; BONE-MINERAL DENSITY; PARATHYROID-HORMONE; EXERCISE CAPACITY; CHILDREN; OPERATION; RISK; ALDOSTERONE; ASSOCIATION Multiple languages Cardiac & Cardiovascular Systems; Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27379