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Low serum 25-hydroxyvitamin D (vitamin D) level among children with ventricular septal defect: how big is the risk for pulmonary hypertension?

Published online by Cambridge University Press:  24 January 2022

Sri E. Rahayuningsih Open the ORCID record for Sri E. Rahayuningsih [Opens in a new window] ,
Rahmat B. Kuswiyanto ,
Putria Rayani ,
Elrika A. Wijaya ,
Mas R. Syamsunarno ,
Raden T. D. Judistiani  and
Budi Setiabudiawan
Sri E. Rahayuningsih*
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Rahmat B. Kuswiyanto
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Putria Rayani
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Elrika A. Wijaya
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Mas R. Syamsunarno
Affiliation:
Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
Raden T. D. Judistiani
Affiliation:
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
Budi Setiabudiawan
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
*
Author for correspondence: S. E. Rahayuningsih, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Jalan Pasteur No. 38, Bandung, West Java 40161, Indonesia. Tel: +6228164870962. E-mail: [email protected]
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Abstract

Introduction:

Ventricular septal defect is the most common CHD, leading to pulmonary hypertension. Significantly lower 25-hydroxyvitamin D level was reported in children with CHD compared with healthy controls. The current study aimed to investigate the correlation between 25-hydroxyvitamin D level and pulmonary hypertension in children with ventricular septal defect.

Methods:

A cross-sectional study was conducted on ventricular septal defect paediatric patients from January to June, 2019. Serum 25-hydroxyvitamin D was measured using electrochemiluminescence. Pulmonary hypertension was defined as mean pulmonary artery systolic pressure > 20 mmHg for children >3 months of age at sea level, measured by Doppler echocardiography.

Results:

From forty-four subjects, the majority of the subjects were female (56.8%) with normal nutritional status and perimembranous ventricular septal defect. Bivariate analysis showed that 25-hydroxyvitamin D level was associated with pulmonary hypertension (p < 0.01), type and size of ventricular septal defect (p = 0.02), and heart failure (p < 0.01). Higher 25-hydroxyvitamin D level was correlated with better nutritional status (p = 0.04, r = 0.26), and lower 25-hydroxyvitamin D level was correlated with the occurence of perimembranous ventricular septal defect (p = 0.01, r = −0.39), larger defect size (p < 0.01, r = −0.70), history of pneumonia (p = 0.02, r = −0.31), and heart failure (p < 0.01, r = −0.64). Subjects with 25-hydroxyvitamin D deficiency had prevalence ratio of 24.0 times for pulmonary hypertension. Higher pulmonary artery pressure was correlated to the occurence perimembranous ventricular septal defect (p = 0.01, r = 0.47), larger defect size (p < 0.01, r = 0.78), history of pneumonia (p = 0.01, r = 0.38), and heart failure (p < 0.01, r = 0.75).

Conclusion:

Children with ventricular septal defect who had low 25-hydroxyvitamin D level posed a higher risk of having pulmonary hypertension.

Keywords

Ventricular septal defectvitamin Dpulmonary hypertension
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 12 , December 2022 , pp. 1984 - 1988
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Park, MK, Salamat, M. Park’s Pediatric Cardiology for Practitioners. 7th edn. Elsevier Inc, Philadelphia, 2021, 124–131.Google Scholar
Gu, Z, Zhang, C, Wei, A, et al. Incidence and risk of respiratory tract infection associated with specific drug therapy in pulmonary arterial hypertension: a systematic review. Sci Rep 2017; 7: 1–9.CrossRefGoogle ScholarPubMed
Wimalawansa, SJ. Non-musculoskeletal benefits of vitamin D. J Steroid Biochem Mol Biol 2018; 175: 60–81.CrossRefGoogle ScholarPubMed
Poh, BK, Rojroongwasinkul, N, Nguyen, BKL, et al. 25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS). Asia Pac J Clin Nutr 2016; 25: 538–548.Google Scholar
Haugen, J, Basnet, S, Hardang, IM, et al. Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia. Pediatr Res 2017; 82: 986–993.CrossRefGoogle ScholarPubMed
Kheiri, B, Abdalla, A, Osman, M, Ahmed, S, Hassan, M, Bachuwa, G. Vitamin D deficiency and risk of cardiovascular diseases: a narrative review. Clin Hypertens 2018; 24: 1–9.Google ScholarPubMed
Wang, T, Sun, H, Ge, H, et al. Association between vitamin D and risk of cardiovascular disease in Chinese rural population. PLoS One 2019; 14: e0217311.CrossRefGoogle ScholarPubMed
Noori, NM, Nakhaee-Moghadam, M, Teimouri, A, Pakravan, A, Boryri, T. 25-hydroxy vitamin D serum levels in congenital heart disease (CHD) children compared to controls. Int J Pediatr 2018; 6: 8129–8138.Google Scholar
Tanaka, H, Kataoka, M, Isobe, S, et al. Therapeutic impact of dietary vitamin D supplementation for preventing right ventricular remodeling and improving survival in pulmonary hypertension. PLoS One 2017; 12: e0180615.CrossRefGoogle ScholarPubMed
Callejo, M, Mondejar-Parreño, G, Esquivel-Ruiz, S, et al. Total, bioavailable, and free vitamin D levels and their prognostic value in pulmonary arterial hypertension. J Clin Med 2020; 9: 448.CrossRefGoogle ScholarPubMed
Callejo, M, Blanco, I, Barberá, JA, Perez-Vizcaino, F. Vitamin D deficiency, a potential cause for insufficient response to sildenafil in pulmonary arterial hypertension. Eur Respir J 2021; 58: 2101204.CrossRefGoogle ScholarPubMed
Callejo, M, Mondejar-Parreño, G, Morales-Cano, D, et al. Vitamin D deficiency downregulates TASK-1 channels and induces pulmonary vascular dysfunction. Am J Physiol Cell Mol Physiol 2020; 319: L627–40.CrossRefGoogle ScholarPubMed
Bouma, S. Diagnosing pediatric malnutrition: paradigm shifts of etiology-related definitions and appraisal of the indicators. Nutr Clin Pract 2017; 32: 52–67.CrossRefGoogle ScholarPubMed
Ross, RD. The Ross classification for heart failure in children after 25 years: a review and an age-stratified revision. Pediatr Cardiol 2012; 33: 1295–1300.CrossRefGoogle Scholar
Holick, MF, Binkley, NC, Bischoff-ferrari, HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline 2011, 25:1911–1930.CrossRefGoogle Scholar
Cresti, A, Giordano, R, Koestenberger, M, et al. Incidence and natural history of neonatal isolated ventricular septal defects: do we know everything? A 6-year single-center Italian experience follow-up. Congenit Heart Dis 2018; 13: 105–112.CrossRefGoogle ScholarPubMed
Hansmann, G, Koestenberger, M, Alastalo, T-P, et al. 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: the European Pediatric Pulmonary Vascular DIsease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT. J Heart Lung Transplant 2019; 38: 879–901.CrossRefGoogle ScholarPubMed
Sciomer, S, Magrì, D, Badagliacca, R. Non-invasive assessment of pulmonary hypertension: doppler-echocardiography. Pulm Pharmacol Ther 2007; 20: 135–140.CrossRefGoogle ScholarPubMed
McNally, JD, Menon, K. Vitamin D deficiency in surgical congenital heart disease: prevalence and relevance. Transl Pediatr 2013; 2: 99–111.Google ScholarPubMed
McNally, JD, Menon, K, Chakraborty, P, et al. The association of vitamin D status with pediatric critical illness. Pediatrics 2012; 130: 429–436.CrossRefGoogle ScholarPubMed
Swales, HH, Wang, TJ. Vitamin D and cardiovascular disease risk: emerging evidence. Curr Opin Cardiol 2010; 25: 513–517.CrossRefGoogle ScholarPubMed
Ku, Y-C. Relationship between vitamin D deficiency and cardiovascular disease. World J Cardiol 2013; 5: 337.CrossRefGoogle ScholarPubMed
Schierbeck, LL, Jensen, TS, Bang, U, Jensen, G, Køber, L, Jensen, JB. Parathyroid hormone and vitamin D—markers for cardiovascular and all cause mortality in heart failure. Eur J Heart Fail 2011; 13: 626–632.CrossRefGoogle ScholarPubMed
Liu, L, Chen, M, Hankins, SR, Nùñez, AE, et al. Serum 25-hydroxyvitamin D concentration and mortality from heart failure and cardiovascular disease, and premature mortality from all-cause in United States adults. Am J Cardiol 2012; 110: 834–839.CrossRefGoogle ScholarPubMed
Ford, JA, MacLennan, GS, Avenell, A, et al. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr 2014; 100: 746–755.CrossRefGoogle ScholarPubMed
Wang, L, Song, Y, Manson, JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012; 5: 819–829.CrossRefGoogle ScholarPubMed
Zhao, J-D, Jia, J-J, Dong, P-S, Zhao, D, Li, D-L, Zhang, H-F. Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials. BMJ Open 2018; 8: e020545.CrossRefGoogle ScholarPubMed
Cepeda, SJ, Zenteno, AD, Fuentes, SC, Bustos, BR. Vitamin D and pediatrics respiratory diseases. Rev Chil Pediatr 2019; 90: 94–101.CrossRefGoogle Scholar