Значение витамина D у больных ишемической болезнью сердца

Objective: to study the relationship between vitamin D status and the cardiovascular system in patients with coronary heart disease (CHD). Material and methods. The study included 102 patients with CHD, stable angina pectoris I–III functional classes according to the Canadian Cardiovascular Society (CCS), who were treated in the laboratory of coronary heart disease and atherosclerosis of the Republican Specialized Scientific and Practical Center of Cardiology (RSSPCC) of the Ministry of Health of the Republic of Uzbekistan, including 39 men and 63 women, average age 61.7 ± 10.0 years old. The concentration of calcidiol was determined in blood serum on an automatic biochemical analyzer «Daytona» from Randox (Great Britain) using test systems from Randox to assess the status of vitamin D. The patients were randomized into 2 groups depending on the baseline value of vitamin D in blood plasma: The 1st group was represented by 67 patients with CHD, whose vitamin D values were below 25 ng/ml; there were 35 patients with coronary artery disease with a vitamin D value of more than 25 ng/ml in the 2nd group. Statistical analysis of the data was carried out using the standard software package for applied statistical analysis (Statistica 10.0, StatSoft, USA). Research results. According to our data, the values of vitamin D did not have gender characteristics in patients with CHD (p = 0.075). Overweight / obesity, diabetes mellitus (DM) and smoking were significantly more common in patients with CHD and a threshold value of vitamin D less than 25 ng/ml (p < 0.05). The values of the thickness of the interventricular septum (IVS) and the left ventricular myocardial mass index (LVMI) corresponded to the signs of left ventricular hypertrophy (LVH) in both groups. A significant difference between the groups was noted only in terms of LVMI: LVH is more pronounced among patients with CHD and a vitamin D value of less than 25 ng/ml: LVMMI corresponded to 133.3 ± 17.6 g/m2 (p < 0.05). Atherosclerotic lesions were determined by sonography of the carotid arteries in 28.4% (19 patients) in the 1st group and 22.8% (8 patients) in the 2nd group (p > 0.05). The thickness of the intima-media complex exceeded the threshold values in our cohort of CHD patients, regardless of the level of vitamin D. Conclusions. The incidence of vitamin D deficiency in patients with coronary artery disease is significant – 65.7%, which is simultaneously accompanied by an increase in the incidence of type 2 diabetes, left ventricular hypertrophy, indicating that vitamin D deficiency is a risk factor for the development of cardiovascular diseases. These findings could have potentially widespread public health implications given the high prevalence of vitamin D deficiency in developed countries, the impact of lifestyle and geography on vitamin D status, and the ease, safety and low cost of treating vitamin D deficiency. Further clinical and experimental studies are needed to validate our findings, examine the mechanisms underlying increased risk of cardiovascular disease, and determine whether correcting vitamin D deficiency can help prevent cardiovascular disease.