Association of myocardial dysfunction with vitamin D deficiency in patients with type 2 diabetes mellitus

J Diabetes Complications. 2014 May-Jun;28(3):286-90. doi: 10.1016/j.jdiacomp.2014.01.003. Epub 2014 Jan 16.

Abstract

Aims: The underlying mechanism of myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM) is unclear. Nonetheless recent studies have revealed that vitamin D (vit-D) deficiency, which is prevalent in such patients, is associated with adverse cardiovascular events. We hypothesized that vit-D deficiency in patients with T2DM may contribute to left ventricular (LV) dysfunction.

Methods: We studied 95 patients (62±9years, 58% female) with T2DM. None had any history of coronary artery disease and all underwent detailed transthoracic echocardiography, including speckle tracking derived strains. Plasma level of 25-hydoxyvitamin D (25-OHD) was also measured.

Results: Vitamin D deficiency was evident in 60 (63%) patients. The LV dimension, LVEF and diastolic grade were similar between those with and without deficiency although an impaired global longitudinal strain was present in the former. Importantly, 25-OHD was negatively associated with global longitudinal strain (R = -0.21, P=0.046) and positively with body-mass index (BMI; R=0.26, P=0.01). Both vit-D deficiency and BMI were associated with impaired global LV longitudinal strain, independent of T2DM disease characteristics.

Conclusions: In patients with T2DM and no history of coronary artery disease, vit-D deficiency is independently associated with impaired global longitudinal strain. This suggests that vit-D deficiency may contribute to the development of myocardial dysfunction in these patients.

Keywords: Diabetes Mellitus; Myocardial dysfunction; Vitamin D deficiency.

MeSH terms

  • Aged
  • Blood Glucose / metabolism
  • Body Mass Index
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Echocardiography
  • Female
  • Heart / physiopathology*
  • Heart Diseases / epidemiology
  • Heart Diseases / physiopathology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / epidemiology
  • Ventricular Dysfunction, Left / physiopathology*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / physiopathology*

Substances

  • Blood Glucose
  • Vitamin D
  • 25-hydroxyvitamin D