June 04, 2019
2 min read

Elevated parathyroid hormone with low vitamin D may predict atrial fibrillation

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Adults with higher parathyroid hormone and lower vitamin D levels are more likely to experience an episode of atrial fibrillation compared with those with normal measures, according to findings published in Nutrition, Metabolism and Cardiovascular Diseases.

Caterina Trevisan

“The relevance of our research is linked in particular to two aspects. First, vitamin D deficiency and high [parathyroid hormone] conditions are extremely common with advancing age, but are often unidentified and untreated,” Caterina Trevisan, MD, of the department of medicine - geriatrics division at the University of Padova in Italy, told Endocrine Today. “Second, atrial fibrillation is the most frequent chronic arrhythmia in older people and is a strong determinant of cardiovascular morbidity, disability and mortality. The relationship between these prevalent entities is therefore an intriguing issue.”

Trevisan and colleagues conducted an observational study with data from 2,418 adults from the Progetto Veneto Anziani cohort (mean age, 76 years, 59.9% women). After being recruited from 1995 to 1997 in northern Italy, participants had serum 25-hydroxyvitamin D and parathormone (PTH) levels measured and were then followed for an average of 4.2 years.

Of the total cohort, 134 participants experienced an event of atrial fibrillation, according to the researchers (incidence rate [IR] = 13.5 per 1,000 person-years; 95% CI, 11.4-15.9). Participants with PTH levels of more than 55 ng/L, which the researchers defined as high, had the highest rate of atrial fibrillation (IR = 16.4; 95% CI, 11.3-24) compared with those with lower measures (IR = 11.9; 95% CI, 9.6-14.6). Conversely, there was no association between having serum 25-(OH)D levels of less than 75 nmol/L, which the researchers considered the cutoff for deficiency, and atrial fibrillation, although the incidence rate increased in combination with high PTH levels (IR = 20.3; 95% CI, 12.9-32.3). In fact, atrial fibrillation risk doubled for those with high PTH and low serum 25-(OH)D levels (HR = 2.09; 95% CI, 1.28-3.42), the researchers reported.

Adults with higher parathyroid hormone and lower vitamin D levels are more likely to experience an episode of atrial fibrillation compared with those with normal measures.
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“Although previous observational and intervention studies showed contrasting results on the relationship between vitamin D and the risk of atrial fibrillation, our study suggests a concurrent role of high PTH and vitamin D deficiency in the development of such disease,” Trevisan said. “Our research may have substantial clinical implications since both low vitamin D and high PTH are modifiable factors, and their cardiovascular effects seem to reverse with the correction of such unbalances.” – by Phil Neuffer

For more information:

Caterina Trevisan, MD, can be reached at caterina.trevisan.5@studenti.unipd.it.

Disclosures: The authors report no relevant financial disclosures.