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Low serum 25-hydroxyvitamin D (vitamin D) level among children with ventricular septal defect: how big is the risk for pulmonary hypertension?

Published online by Cambridge University Press:  24 January 2022

Sri E. Rahayuningsih*
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Rahmat B. Kuswiyanto
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Putria Rayani
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Elrika A. Wijaya
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Mas R. Syamsunarno
Affiliation:
Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
Raden T. D. Judistiani
Affiliation:
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
Budi Setiabudiawan
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
*
Author for correspondence: S. E. Rahayuningsih, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Jalan Pasteur No. 38, Bandung, West Java 40161, Indonesia. Tel: +6228164870962. E-mail: seraning@yahoo.com

Abstract

Introduction:

Ventricular septal defect is the most common CHD, leading to pulmonary hypertension. Significantly lower 25-hydroxyvitamin D level was reported in children with CHD compared with healthy controls. The current study aimed to investigate the correlation between 25-hydroxyvitamin D level and pulmonary hypertension in children with ventricular septal defect.

Methods:

A cross-sectional study was conducted on ventricular septal defect paediatric patients from January to June, 2019. Serum 25-hydroxyvitamin D was measured using electrochemiluminescence. Pulmonary hypertension was defined as mean pulmonary artery systolic pressure > 20 mmHg for children >3 months of age at sea level, measured by Doppler echocardiography.

Results:

From forty-four subjects, the majority of the subjects were female (56.8%) with normal nutritional status and perimembranous ventricular septal defect. Bivariate analysis showed that 25-hydroxyvitamin D level was associated with pulmonary hypertension (p < 0.01), type and size of ventricular septal defect (p = 0.02), and heart failure (p < 0.01). Higher 25-hydroxyvitamin D level was correlated with better nutritional status (p = 0.04, r = 0.26), and lower 25-hydroxyvitamin D level was correlated with the occurence of perimembranous ventricular septal defect (p = 0.01, r = −0.39), larger defect size (p < 0.01, r = −0.70), history of pneumonia (p = 0.02, r = −0.31), and heart failure (p < 0.01, r = −0.64). Subjects with 25-hydroxyvitamin D deficiency had prevalence ratio of 24.0 times for pulmonary hypertension. Higher pulmonary artery pressure was correlated to the occurence perimembranous ventricular septal defect (p = 0.01, r = 0.47), larger defect size (p < 0.01, r = 0.78), history of pneumonia (p = 0.01, r = 0.38), and heart failure (p < 0.01, r = 0.75).

Conclusion:

Children with ventricular septal defect who had low 25-hydroxyvitamin D level posed a higher risk of having pulmonary hypertension.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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