Should vitamin D status be assessed in patients with congestive heart failure?
For decades the vitamin D biological system has been considered almost exclusively as the master integrator of calcium-phosphate homeostasis and bone metabolism. More recently, the discovery that many human tissues and cells, which do not directly participate in mineral ion homeostasis, express the vitamin D receptor (VDR) and are able to convert the circulating pro-hormone 25-hydroxyvitamin D in its active form, 1,25-dihydroxyvitamin D, has provided new insights into the biological function of this peculiar endocrine system. Several reports have highlighted a variety of human diseases possibly related to vitamin D insufficiency or deficiency (respectively defined as 25-hydroxyvitamin D serum levels lower than 30 or lower than 20 ng/ml). In particular, experimental and observational studies, including those published in this journal issue, support the concept that vitamin D deficiency is involved in the pathogenesis of congestive heart failure, a disabling condition affecting over 15 million of patients worldwide. Considering that circulating levels of 25-hydroxyvitamin D represent the accepted clinical indicator of individual vitamin D status, the measurement of this pro-hormone can be regarded as an appropriate and cost-effective screening tool in patients with chronic heart failure.
Rendina
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Department of Clinical and Experimental Medicine, Federico II University of Naples Medical School, Naples, Italy.
De Filippo
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Strazzullo
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D000818:Animals; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D018167:Receptors, Calcitriol / Q000502:physiology; D012084:Renin-Angiotensin System; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000502:physiology; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control
D018167:Receptors, Calcitriol; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D