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

Abstract

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.

Bone Mineral Density in Lung Transplant Recipients: Experience of A Referral Lung Transplantation Center

“…2,3 Osteoporosis is one of the important causes of morbidity after lung transplantation, and fractures resulting from it can significantly affect the life expectancy of patients. Numerous studies have documented the degree of bone mass loss that occurs after kidney [4][5][6] , heart 7,8 , and liver [9][10][11] transplantation. Lung transplantation has been associated with a decrease in bone mass index, but there are few studies on this topic.…”

Vitamin D in Health and Disease

“…In particular, the addition of VD increases peroxisome proliferator-activated receptor gamma (PPAR)-γ1 levels, CPT-1A and ABCA1 proteins, while, by contrast, it blocks the increase in both CD-36 and C/EB proteins induced through FFA administration. Abulmeaty et al [18] reported that VD deficiency is frequently present in heart transplant (HT) patients, but a 2-year supplementation of VD did not seem to have a positive impact on the bone mineral density (BMD). Furthermore, obesity represents an independent risk factor for the onset of cardiovascular diseases, for which vitamin D levels have not appeared to have any positive impact.…”