Materials and Methods
Our study is a cross-sectional, observational study, includes
premenopausal women aged 18-50 who applied to internal disease and were
diagnosed with VDD. Our study was carried out in Bilecik City in the
period November-December 2020. Bilecik, located at an approximate
altitude of 500 meters and a latitude of 40°N, is a small city in
Turkey. During the study period, the average temperature in Bilecik city
was determined as 8.5 degrees Celsius (maximum 13°C, minimum 2°C).
The fasting routine blood samples (including PTH levels) were
investigated of these patients’ internal medicine records. In evaluating
VitD, the serum circulating 25-hydroxyvitamin D [25(OH)D] level was
measured. VDD was defined as a serum 25-hydroxyvitamin D level of
<20 ng/ml, and severe VDD was also defined as a serum
25-hydroxyvitamin D level of <10 ng/ml (30). Patients
diagnosed with VDD who have not yet started replacement therapy were
evaluated using essential echocardiographic evaluation, brachial and
carotid tissue doppler, and flow-mediated dilatation. Local ethics
committee approval was obtained.
Patients diagnosed with diabetes mellitus, hypertension, hyperlipidemia,
coronary artery disease, congestive heart failure, peripheral artery
disease, moderate-severe heart valve disease, cardiomyopathies, thyroid
dysfunction, chronic obstructive pulmonary disease, malignancy,
rheumatological disease, active infection, kidney failure, liver
disease, hormonal diseases (affecting calcium level, including primary
hyperparathyroidism), obesity (BMI>30), drug usage
(including beta-blockers and medications affect calcium level),
menopause, pregnancy, and heavy alcohol users and smokers were excluded
from the study. A total of 68 patients were included in the survey by
excluding patients with low echogenicity.
Patients were divided into two groups according to their PTH levels.
While PTH levels were in the normal reference range (<65
pg/ml) in 41 patients, it was high in 27 patients. Groups were compared
in terms of basal demographic characteristics, standard
echocardiographic evaluation, carotid and brachial artery tDi features.