65 Yaş ve Üstü Yaşlı Hastalarda Vitamin D Düzeyi ile Santral Kan Basıncı, Augmentasyon Indeksi ve Flow-Mediated Dilation (Fmd) Arası Ilişki

Abstract

Recent studies suggest a possible association between vitamin D deficiency and many cardiovascular disorders. The studies evaluating this relationship in geriatric population are not enough. The purpose of this study is evaluating the relationship between vitamin D level and central blood pressure (CBP), augmentation index (AI), and flow-mediated dilation (FMD) which has been shown to be associated with cardiovascular risk, in geriatric population. A total of 201, 65 years and over patients who were referred to the outpatient clinic of Geriatric Medicine at Hacettepe University Hospital, from november 2012 to may 2013 were included in the study. The patients without known cardiac disease, advanced dementia, taking vitamin D supplementation and the patients taken informed consent were included the study. Comprehensive geriatric assessment and physical examination were performed. Blood samples were taken, and then CBP, AI and FMD measured. Patients were evaluated in three groups as vitamin D deficiency <15 ng/ml, vitamin D insufficiency 15-29.9 ng/ml and vitamin D sufficiency ?30 ng/ml. As vitamin D increases, parathyroid hormone (p=0.01) and triglyceride (p=0.006) levels were shown to be decrease. Between groups, while vitamin D increasing, CBP and AI (at 75 beats/min) were decreasing, but there was no significant difference (respectively p=0.36,p=0.65). Also, increasing vitamin D levels were associated positively with increasing FMD (respectively 9.6±4.8, 10.2±5, 19.3±14.2, p=0.005). The regression analysis showed that, FMD associated independently with vitamin D. In conclusion, vitamin D deficiency is associated with endothelial dysfunction and cardiovascular risk in the elderly. But, relationship between vitamin D and cardio-metabolic risk factors in geriatric population must be evaluated in larger studies.