title: Severely vitamin D-deficient athletes present smaller hearts than sufficient athletes.
abstract: BACKGROUND
  Vitamin D (25(OH)D) deficiency has associations with bowl/colon cancer, arthritis, diabetes, and cardiovascular disease. Many athletes are vitamin D deficient, yet no studies have examined the association between 25(OH)D status and cardiac structure and function in healthy athletes.
  
  
  METHODS
  A total of 506 national-level athletes [football (50%), handball (23%), volleyball (16%), and basketball (11%)] and 244 control participants presented for precompetition medical assessment. Controls were healthy individuals registered with a sporting federation undertaking <2 h of exercise per week.
  
  
  METHODS
  All individuals undertook a physical examination, 12-lead electrocardiogram, echocardiogram, and serum 25(OH)D evaluation.
  
  
  RESULTS
  From 506 athletes and 244 controls, 23 and 12.3% demonstrated 25(OH)D sufficiency (>30 ng/ml), 30 and 23.4% insufficiency (20-30 ng/ml), 37.2 and 48.8% deficiency (10-20 ng/ml), and 11 and 15.6% severe deficiency (<10 ng/ml). Severely 25(OH)D-deficient athletes present significantly (p < 0.05) smaller aortic root and left atria diameters, intraventricular septum diameter (IVSd), left ventricular diameter during diastole (LVIDd), left ventricular mass (LVM), left ventricular volume during diastole (LVvolD), and right atrial (RA) area than insufficient and sufficient athletes. Furthermore, following logarithmic transformation adjusting 25(OH)D for age, body surface area, ethnicity, and athletic participation, positive associations were observed between 25(OH)D and IVSd, LVIDd, posterior wall thickness during diastole, LVM, and LVvolD in athletes but not in the control participants.
  
  
  CONCLUSIONS
  Severely 25(OH)D-deficient athletes present significantly smaller cardiac structural parameters than insufficient and sufficient athletes. Future research should investigate the precise mechanism(s) causing cardiac hypertrophy with increases in serum 25(OH)D in healthy athletes.
authors.affiliation: National Sports Medicine Program, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK richard.allison@aspetar.com.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Allison
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK.
authors.forename: Graeme L
authors.initials: GL
authors.lastname: Close
authors.affiliation: Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital Qatar.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Farooq
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital Qatar.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Riding
authors.affiliation: Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar.
authors.forename: Othman
authors.initials: O
authors.lastname: Salah
authors.affiliation: High Performance Sport New Zealand, Auckland, New Zealand.
authors.forename: Bruce
authors.initials: B
authors.lastname: Hamilton
authors.affiliation: Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar.
authors.forename: Mathew G
authors.initials: MG
authors.lastname: Wilson
mesh_terms: D000328:Adult; D056352:Athletes; D015415:Biomarkers; D059267:Cardiomegaly, Exercise-Induced; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D006321:Heart / Q000254:growth & development* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009929:Organ Size; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Athlete’s heart; cardiac structure and function; vitamin D deficiency