Is There an Increased Risk for Thrombosis in The Patients with Vitamin D Deficiency?

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 257-280-Disorders of Vitamin D Metabolism & Action
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-270
Oya Topaloglu1, Muyesser Sayki Arslan1, Melia Karakose1, Bekir Ucan1, Zeynep Ginis1, Evrim Cakir1, Taner Demirci1, Mustafa Sahin2, Mustafa Ozbek1, Erman Cakal*1 and Tuncay Delibasi1
1Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, 2Ankara Univercity Faculty of Medicine, Ankara, Turkey
Objective: Vitamin D is not only plays an important role in calcium homeostasis and bone remodeling, but it is also associated with hypertension, muscular function, immunity, and ability to  encounter infection, autoimmune disease and cancer. There was limited data from in vitro studies concerning the pro-fibrinolytic, antitrombotic effect of vitamin D. However, the role of vitamin D in hemostatic process is still unclear. The aim of this study was to evaluate the relationship between vitamin D levels and coagulation parameters

Methods: All subjects applying to our clinic between December 2011 and February 2012 for whom 25 OH vitamin D3 (25OHD3) levels measured for any reason were included to this cross-sectional study. Those with a history of diabetes mellitus, impaired glucose tolerance, laboratory findings of renal or hepatic dysfunction, a coagulation disorder, atherosclerotic disease, and those of any form of medication effect on coagulation parameters were excluded. Coagulation parameters were measured including prothrombin time (PTT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, homocysteine, tissue factor pathway inhibitor (TFPI), thrombomodulin, and tissue plasminogen activator (t-PA). Patients were divided into 3 groups based on levels of 25OHD3 as Group 1 (25OHD3< 10 ng/mL, n= 25), Group 2 (25OHD3=10-19.9 ng/mL, n=22) , and Group 3 (25OHD3≥20 ng/mL, n=28).

Results: A total of 75 patients mean aged 39 (range; 18-57) years were included in the study. Age, body mass index and sex were similar between groups (p>0.05). PTT was longer in group 3 than group 2 (p=0.043). Tęssue factor pathway inhibitor levels were higher in patients in group 3 compared to the other groups (p<0.0001). The correlation analyses were performed and it was found a strong positive correlation between 25OHD3 and TFPI levels (r=0.47, p<0.0001). There was no significant correlation between 25OHD3 and other coagulation parameters.

Conclusion: TFPI is a major inhibitor of coagulation. We demonstrated lower TFPI values in patients with 25OHD3 levels less than 20 ng/mL. Coagulation parameters indicate that the patients with low vitamin D levels are more prone to thrombosis. Therefore, more attention should be focused on vitamin D deficiency and this needs to be investigated in prospective studies. The change in coagulation parameters with vitamin D treatment should be also evaluated in further studies.

Nothing to Disclose: OT, MS, MK, BU, ZG, EC, TD, MS, MO, EC, TD

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