Endocrine Abstracts

Introduction: Heart Failure with Preserved Ejection Fraction (HFpEF) morbidity and mortality are increasing at an alarming rate in patients with prediabetes, insulin resistance and obesity. Vitamin D deficiency is associated with the risk of impaired glucose and lipid metabolism. All this substantiates the need to monitor the concentration vitamin D in women with this comorbid pathology.

Aim of the study: is to investigate the severity of vitamin D deficiency in females with prediabetes and HFpEF.

Materials and methods: Participants were comprehensively phenotyped including physical examination, laboratory results and echocardiography (left ventricular ejection fraction (LVEF) >50%). Main group included 30 women with prediabetes and HFpEF (initially mean aged 49.54 ±1.63 years, body mass index (BMI) - 35.24±2.21 kg/m², glycated hemoglobin (HbA₁C) - 6.05±0.13% and duration of prediabetes - 3.22±2.19 years, N-terminal pro-brain natriuretic peptide (NT-proBNP) -161.51±7.27 pg/ml, left ventricle (LV) mass index 112±24, LVEF – 59.43±7.39%) were divided into groups: I group (Gr I, n=15) females with insufficiency of 25-hydroxycholecalciferol (25(OH)D - 20-30 ng/ml) and II group (Gr II, n=15) subjects with hypovitaminosis D (25(OH)D below 20 ng/ml. The patients were treated metformin XR (daily dose - 500-1500 mg) combination cholecalciferol (vitamin D3) (daily dose Gr I – 5000 IU and Gr II– 20 000 IU) during 3 months. The physical examination and all laboratory, instrumental results were measured at baseline and 3 months following the treatment. Results were analyzed with IBM SPSS Statistics. Significance level P<0.05 was considered.

Results: The mean of 3 months after add metformin XR and vitamin D3 on BMI and HbA₁C level was lowered by 0.77% and 0.81% each in two groups. On comparing with the baseline the mean deference of 25(OH)D after combination therapy were increase mean 52.5% in Gr I and 63.8% in Gr II. After adjustment, higher serum levels 25(OH)D were associated with decreased hazard for NT-proBNP (102.11±3.14 pg/ml) and LV mass index overall (101± 22) driven by a significant association with HFpEF (increase mean LVEF (71.32±8.89%) for 1.2 time).

Conclusions: Particularly the association between vitamin D deficiency and comorbid diseses: prediabetes, obesity in women with HFpEF. During the war in Ukraine, there is a probable deepening hypovitaminosis D. Increased NT-proBNP, HbA₁C, BMI and LV mass index were associated with vitamin D deficiency. The insufficiency and deficiency vitamin D negatively influenced ejection fraction in females with prediabetes.