Association of activated vitamin D use with myocardial fibrosis and capillary supply: results of an autopsy study

Figures & data

Table 1. Baseline characteristics.

Variable N (%)	No vitamin D use (n = 32)	Baseline vitamin D use (n = 12)	p-Value
Age (years), mean (SD)	64.8 (14.0)	65.9 (14.9)	0.82
Male sex	20 (63)	5 (42)	0.21
Race
White	24 (77)	7 (58)	0.43
Black	5 (16)	4 (33)
Other	2 (6)	1 (8)
Renal function
Preserved function	17 (53)	3 (25)	0.10
Stage 3-4 CKD	28 (90)	5 (42)
ESRD	3 (9)	4 (33)
Estimated GFR (mL/min/1.72 m^2), median (IQR)	67.6 (46.9, 104.8)	37.8 (15.3, 86.9)	0.14
Creatinine (mg/dL), median (IQR)	1.1 (0.8, 1.3)	2.2 (0.8, 4.0)	0.22
Smoking	17 (59)	4 (33)	0.14
Diabetes	10 (31)	8 (67)	0.03
Hypertension	25 (78)	11 (92)	0.30
Coronary artery disease	15 (47)	3 (25)	0.19
Anemia	7 (24%)	8 (67%)	0.01
Labs*
Parathyroid hormone, (pg/mL)	149.2 (202.1)	284.7 (166.3)	0.22
Calcium (mg/dL), median (IQR)	8.9 (8.4, 9.4)	9.2 (8.6, 10.4)	0.41
Phoshporous (mg/dL)	4.4 (2.0)	5.1 (–)	0.75
Hyperparathyroidism	4 (31)	7 (78)	0.03
Cause of death
Infection	10 (31)	3 (25)	0.88
Cardiovascular	11 (34)	5 (42)
Other	11 (34)	4 (33)
Medications
ACE inhibitor	7 (22)	5 (42)	0.19
Angiotensin receptor blocker	4 (13)	1 (8)	0.70
Erythropoietin stimulating agent	3 (9)	5 (42)	0.01
Beta blocker	18 (56)	7 (64)	0.67
Phosphate binder therapy	3 (10)	7 (58)	<0.01

Notes: IQR—interquartile range, CKD—chronic kidney disease, SD—standard deviation, GFR—glomerular filtration rate, ACE—angiotensin converting enzyme.

*Bone and mineral metabolism labs were available for only a subset of participants: No vitamin D use—parathyroid hormone (n = 5), serum calcium (n = 25), phosphorous (n = 7); vitamin D use—parathyroid hormone (n = 8), serum calcium (n = 8), phosphorous (n = 1).

Figure 1. Fibrosis of the left ventricle in individuals with and without exogenous vitamin D exposure. Representative images of left ventricle from patients with (A) and without (B) exogenous vitamin D exposure. Left ventricle sections were paraffin embedded, sectioned at 5 µm and trichrome stained using standard techniques and visualized at 100× magnification.

Table 2. Crude and adjusted associations of vitamin D and myocardial histology.

Variable mean (SD)	No vitamin D use (n = 32)	Baseline vitamin D use (n = 12)	p-Value	Adjusted β* (95% CI)	p-Value
Histology
Fibrosis (%)	13.19 (5.77)	10.49 (4.38)	0.15	−3.86 (−7.35, −0.36)	0.03
Microvessels/field	434.84 (109.08)	412.486 (37.91)	0.49	−4.61 (−75.45, 66.22)	0.90
Cardiomyocytes/field, median(IQR)	559.79 (482.15, 697.95)	587.25 (514.43, 668.50)	0.83	0.09 (−0.10, 0.28)	0.33
Myocyte size (µM^2), median (IQR)	584.79 (642.87, 930.60)	517.65 (685.91, 891.33)	0.20	−0.18 (−0.39, 0.04)	0.10

Notes: Histology models adjusted for CKD stage, vitamin D use, sex, age, hypertension and diabetes. IQR—interquartile range, CKD—chronic kidney disease, SD—standard deviation, GFR—glomerular filtration rate, β—linear regression coefficient, CI—confidence interval.

*Due to non-normality, β is provided for models with log transformed outcome variables for cardiomyocytes per field and myocyte size variables.