Federica Saponaro1, Alessandro Saba2, Sabina Frascarelli3, Concetta Prontera4, Aldo Clerico5, Marco Scalese6, Maria Rita Sessa7, Filomena Cetani8, Simona Borsari9, Elena Pardi10, Antonella Marvelli11, Claudio Marcocci12, Claudio Passino13, Riccardo Zucchi14. 1. F Saponaro, Laboratory of Biochemistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy, Pisa, Italy federica.saponaro@gmail.com. 2. A Saba, Laboratory of Biochemistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy, Pisa, Italy. 3. S Frascarelli, Laboratory of Biochemistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy, Pisa, Italy. 4. C Prontera, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. , pisa, Italy. 5. A Clerico, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. , Pisa, Italy. 6. M Scalese, Institute of Clinical Physiology, National Council of Research, Pisa, Italy, , Pisa, Italy. 7. M Sessa, Laboratory of Endocrinology, University Hospital of Pisa, Pisa, Italy, Pisa, Italy. 8. F Cetani, Endocrinology Unit 2, University of Pisa, Pisa, Italy, Pisa, Italy. 9. S Borsari, Endocrinology Unit 2, University of Pisa, Pisa, Italy, Pisa, Italy. 10. E Pardi, Endocrinology Unit 2, University of Pisa, Pisa, Italy, pisa, Italy. 11. A Marvelli, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, , Pisa, Italy. 12. C Marcocci, Endocrinology Unit 2, University Hospital of Pisa, Pisa, Italy. , Pisa, Italy. 13. C Passino, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. , Pisa, Italy. 14. R Zucchi, Laboratory of Biochemistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy. , Pisa, Italy.
Abstract
OBJECTIVES: The aims of this paper were to evaluate the levels of Vitamin D (VitD) in patients with Heart Failure (HF), compared to a control group, to assess the effects of VitD on HF outcome and to compare VitD measurement between LIAISON immunoassay and HPLC-MS-MS methods in this population. DESIGN & METHODS: We collected clinical, biochemical and outcome data from 247 patients with HF and in a subgroup of 151 patients, we measured VitD both with LIAISON and HPLC-MS-MS. RESULTS: HF patients had statistically lower 25OHD levels (45.2±23.7 nmol/l vs 58.2±24.0 nmol/l, p<0.001) and a statistically higher prevalence of VitD insufficiency (61.1% vs 39.5%, p<0.001) and deficiency (24.7% vs 6.6%, p<0.001), compared to healthy controls. There was a significant inverse relationship between baseline 25OHD and risk of HF related death, with a HR of 0.59 (95% CI 0.37-0.92, p=0.02), confirmed in a multivariate adjusted analysis. Kaplan-Meier survival analyses showed that VitD insufficiency was associated with reduced survival in HF patients (log rank p=0.017). There was a good agreement between LIAISON and HPLC-MS-MS (Cohen's kappa coefficient 0.70), but the prevalence of vitamin D insufficiency was significantly higher with the former compared to the latter method (58.3%, n=88 vs 55.6%, n=84, p<0.001). LIAISON underestimated the 25OHD levels and showed a mean relative bias of -0.739% with 95% of limits of agreement (-9.00 to +7.52%), when compared to HPLC-MS-MS. CONCLUSIONS: 25OHD levels adequately measured by HPLC-MS-MS, showed to be low in HF population and to be correlated with HF-related risk of death.
OBJECTIVES: The aims of this paper were to evaluate the levels of Vitamin D (VitD) in patients with Heart Failure (HF), compared to a control group, to assess the effects of VitD on HF outcome and to compare VitD measurement between LIAISON immunoassay and HPLC-MS-MS methods in this population. DESIGN & METHODS: We collected clinical, biochemical and outcome data from 247 patients with HF and in a subgroup of 151 patients, we measured VitD both with LIAISON and HPLC-MS-MS. RESULTS: HF patients had statistically lower 25OHD levels (45.2±23.7 nmol/l vs 58.2±24.0 nmol/l, p<0.001) and a statistically higher prevalence of VitD insufficiency (61.1% vs 39.5%, p<0.001) and deficiency (24.7% vs 6.6%, p<0.001), compared to healthy controls. There was a significant inverse relationship between baseline 25OHD and risk of HF related death, with a HR of 0.59 (95% CI 0.37-0.92, p=0.02), confirmed in a multivariate adjusted analysis. Kaplan-Meier survival analyses showed that VitD insufficiency was associated with reduced survival in HF patients (log rank p=0.017). There was a good agreement between LIAISON and HPLC-MS-MS (Cohen's kappa coefficient 0.70), but the prevalence of vitamin D insufficiency was significantly higher with the former compared to the latter method (58.3%, n=88 vs 55.6%, n=84, p<0.001). LIAISON underestimated the 25OHD levels and showed a mean relative bias of -0.739% with 95% of limits of agreement (-9.00 to +7.52%), when compared to HPLC-MS-MS. CONCLUSIONS: 25OHD levels adequately measured by HPLC-MS-MS, showed to be low in HF population and to be correlated with HF-related risk of death.
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