Endocrine Abstracts

JOINT1119

Background and aims: Iron and vitamin D deficiencies are two of the most common nutrient deficits in the world. Frequently when it comes to such significant pathologies as diabetes or heart failure (HF) we simply lose focus on nutritional support, which can improve quality of life and alleviate symptoms that may be caused by nutrient deficiencies rather than the underlying diseases. Aim of the study is to evaluate associations between iron status and vitamin D level with inflammation caused by underlying diseases in females with type 2 diabetes mellitus (T2DM) and HFpEF.

Materials and methods: 30 women with T2DM and HFpEF (mean age -58,4±1,3 years; body mass index (BMI)- 33,8± 2,5 kg/m², waist circumference (WC) - 103,5±1,9 cm, glycated hemoglobin (HbA₁C)- 7,1±0,1% and duration of T2DM -7,7±0,8 years) were comprehensively phenotyped including physical examination, laboratory (N-terminal pro-brain natriuretic peptide (NTproBNP), ferritin, transferrin saturation (TSAT), glycated hemoglobin (HbA₁C), 25-hydroxycholecalciferol (25(OH)D) and C-reactive protein (CRP)) and instrumental (echocardiography: left ventricular ejection fraction (LVEF) >50%) results.

Results: 25(OH)D concentrations <30 ng/mL were presented in 86,7% patients, 3,3% females had 25(OH)D level>30 ng/mL. ID were presented in 23 (76,7%) women against 23,3%. Women with 25(OH)D concentrations <30 ng/ml had reduced ferritin, TSAT levels compared to those with 25(OH)D concentrations >30 ng/ml. The prevalence of ID was in 21 (80,8%) females with 25(OH)D concentrations <30 ng/ml compared to 5 (25%) in those with concentrations >30 ng/mL. Alike the prevalence of low vitamin D level was higher in women with ID 87% against 13% to those who had adequate iron status. Due to fact that inflammation alters of iron status and differs by vitamin D level, we investigated level of CRP and evaluated interactions between inflammation and 25(OH)D concentrations in predicting iron status. In patients with inflammation 36,7% we observed higher 25(OH)D concentrations in combination with lower ferritin level than in those without inflammation 63,3%.

Conclusions: Low Vitamin D level was associated with increased risk of ID in women with T2DM and HFpEF 87%, similarly as iron deficient women with type 2 DM and HFpEF had a higher risk of low vitamin D status. Chronic inflammation inherent T2DM and HF could increased ID which may be inhibiting with high doses of vitamin D.