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Sun exposure influences the prognostic power of components of mineral metabolism in patients with coronary artery disease.
- Source :
-
Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2017 Sep; Vol. 27 (9), pp. 762-767. Date of Electronic Publication: 2017 Jun 15. - Publication Year :
- 2017
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Abstract
- Background and Aim: Calcidiol (vitamin D metabolite) plasma levels vary with sun exposure (SE). However, it is not known if SE influences its prognostic ability. We have studied the effect of SE on plasma levels of the components of mineral metabolism (calcidiol, fibroblast growth factor-23 [FGF-23], parathormone [PTH], and phosphate [P]) and on their prognostic value in patients with coronary artery disease (CAD).<br />Methods and Results: We studied prospectively 704 patients with stable CAD. Clinical variables and baseline calcidiol, FGF-23, PTH, and P plasma levels were assessed. We divided the population in two subgroups, according to the period of plasma extraction: High SE (HSE) (April-September) and low SE (LSE) (October-March). The outcome was the development of acute ischemic events (acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Mean follow-up was 2.15 ± 0.99 years. Calcidiol and P levels were higher in HSE group. In the whole population, calcidiol (HR = 0.84 for each 5 ng/ml increase, 95% CI = 0.71-0.99; p = 0.038) and FGF-23 (HR = 1.14 for each 100 RU/ml increase, 95% CI = 1.05-1.23; p = 0.009) were predictors of the outcome, along with age, hypertension, body-mass index, peripheral artery disease, and P levels. In the LSE subgroup, calcidiol (HR = 0.75; 95% CI = 0.57-0.99; p = 0.034) and FGF-23 (HR = 1.34; 95% CI = 1.13-1.58; p = 0.003) remained as predictors of the outcome. In the HSE group calcidiol and FGF-23 had not independent prognostic value.<br />Conclusions: In patients with stable CAD, low calcidiol and high FGF-23 plasma levels predict an adverse prognosis only when the sample is obtained during the months with LSE. SE should be taken into account in the clinical practice.<br /> (Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Acute Coronary Syndrome etiology
Acute Coronary Syndrome mortality
Aged
Biomarkers blood
Coronary Artery Disease complications
Coronary Artery Disease diagnosis
Coronary Artery Disease mortality
Female
Fibroblast Growth Factor-23
Heart Failure etiology
Heart Failure mortality
Humans
Ischemic Attack, Transient etiology
Ischemic Attack, Transient mortality
Male
Middle Aged
Parathyroid Hormone blood
Phosphates blood
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Factors
Spain
Stroke etiology
Stroke mortality
Time Factors
Calcifediol blood
Coronary Artery Disease blood
Fibroblast Growth Factors blood
Seasons
Sunlight
Subjects
Details
- Language :
- English
- ISSN :
- 1590-3729
- Volume :
- 27
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Nutrition, metabolism, and cardiovascular diseases : NMCD
- Publication Type :
- Academic Journal
- Accession number :
- 28803689
- Full Text :
- https://doi.org/10.1016/j.numecd.2017.06.006