engleski

Vitamin D in diabetic patients with acute coronary syndrome.

Aims: To determine the relationship of 25- hydroxyvitamin D (25(OH)D) serum concentration with acute coronary syndrome (ACS) with review on subgroup of diabetic patients. Methods: 60 patients age between 30 and 70 year treated for ACS: STEMI and NSTE-ACS at General Hospital in Slavonski Brod, Croatia, and 60 control subjects free from ACS including DM, obesity, smoking, hypertension, and hyperlipidemia, as a control. All routine laboratory tests and plasma PTH and 25(OH)D done. Analysis was performed by use of the SPSS for Windows 11.0.3 software (SPSS Inc., Chicago, IL, USA). p<0.05. Results: The ACS group included 36 (60 %) patients with STEMI and 24 (40 %) patients with NSTEMI-ACS. Serum levels of 25(OH)D: 35.19±17.54 nmol/L in ACS patients was statistically significantly lower than in controls: 58.08± 16.29 nmol/L, ACS patients had three subgroups regarding coronary disease severity: single(SVCAD) (n=39 ; 68 %), double (DVCAD) (n=15 ; 26 %) and multiple vessel disease (MVCAD) (n=3 ; 6 %) and they had 25(OH)D serum levels of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L, respectively. Statistically significantly was higher rate of vitamin D insufficiency among ACS patients as compared with the control group, Vitamin D deficiency was recorded in as many as 20 % of ACS patients and none of control subjects. In the ACS group, patients with DM female (F) (n=9, 40 %) and male (M) (n=13, 60 %) had the lowest mean 25(OH)D concentration of 30.45±15.05 mmol/L in comparison to all subgroups. A similar tendency toward a lower mean 25(OH)D level of 46.60±19.26 mmol/L in DM patients was also recorded in the control group, and this difference was statistically significant. In diabetic group we found STEMI (N=14 ; 64 %)+NSTEMI (n=8 ; 36 %) and SVCAD (n=15 ; 68 %)+DVCAD (n=6 ; 27 %)+MVCAD (n=1 ; 5 %). Conclusion: Patients with diabetes had significantly low levels of vitamin D3 in ACS. Is it an accidental finding or a distorted reflection of atherogenesis due to low levels of vitamin D in diabetes? Perhaps low vitamin D levels only increase atherogenicity and become one of the triggers for the development of ACS. Studies are needed to confirm the need for the normal level of vitamin D for prevention of ACS. Perhaps it is necessary to pay more attention to the level of vitamin D3 in diabetics. References: 1 Zittermann A et al., Am J Clin Nutr 2012 ; 95:91. 2.von Essen MR et al., Nat Immunol 2010 ; 11:344.

Vitamin D ; diabetic patients ; acute coronary syndrome.

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