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.