Vitamin D status and associated factors in individuals with heart failure.
Heart failure; vitamin D; functional class.
Hypovitaminosis D has been a frequent finding in subjects with heart failure (HF), especially in those with lower functional capacity. The aim of this study was to evaluate the vitamin D status against clinical aspects of HF and possible associated factors. A cross-sectional study was performed with 70 adult and elderly individuals diagnosed with HF, distributed in 3 groups according to the functional classification proposed by the New York Heart Association (NYHA) (n = 46 - NYHA I; n = 14 - NYHA II; n = 10 NYHA III / IV). Clinical, anthropometric, lifestyle, skin phototype and sun exposure data were evaluated. Blood samples were collected for analysis of 25-hydroxyvitamin D (25OHD) and other biochemical parameters. 25OHD was analyzed by the electrochemiluminescence immunoassay method. Those with values <30ng / mL were considered insufficient / deficient. Vitamin D, calcium and phosphorus intake were assessed by a 24-hour recall. The Generalized Linear Models Theory (MLG) was applied for inferential analysis. The relationship between the independent variables and the 25OHD concentration was established crude and adjusted. The Wald chi-square test was applied to determine the difference between subgroups. The mean age was 53.24 (14.95) years, with a predominance of males (64.3%). No significant difference was observed between functional groups (both p> 0.05). The mean 25OHD concentration was 40.09 (12.44) ng / dL, with 24.3% of individuals presenting vitamin D insufficiency / deficiency. The mean 25OHD was 42.47 (1.75) ng / dL for NYHA I, 36.52 (3.17) ng / dL for NYHA II and 34.12 (3.75) ng / dL for NYHA III / IV, with no significant difference between groups (p = 0.06). A lower exercise (p <0.001) and sun exposure (p = 0.024) were observed in the NYHA III / IV group compared to NYHA I. The adjusted analysis revealed associations between functional class and 25OHD concentrations, with a marginal difference between NYHA I and III / IV (B = -11.824; p = 0.068) and a significant difference between NYHA II and III / IV ( B = -13,747, p = 0.033). An inverse relationship between PTHi and 25OHD (B = -0.054; p = 0.026) was also evidenced. 25OHD was significantly higher in male subjects (B = 9,941, p = 0.004) and in those who did not use platelet antiaggregant (B = 9,474, p = 0.001). In conclusion, In conclusion, clinical aspects demonstrated a relationship with 25OHD, as well as concentrations of PTHi, sex and antiplatelet use, reinforcing the importance of evaluating the factors interfering in the vitamin D status to better target clinical-nutritional behaviors.