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Evaluation of Vitamin B12 And Vitamin D Levels in Patients With Deep Vein Thrombosis

Yıl 2022, Cilt: 19 Sayı: 1, 208 - 214, 28.04.2022
https://doi.org/10.35440/hutfd.1063465

Öz

Background: Deep vein thrombosis (DVT) is an important cause of mortality and morbidity that occurs due to many causes. Autoimmune diseases, malignancies, previous major surgical interventions, immobility and hyperhomocysteinemia, metabolic diseases predispose to DVT. There are studies suggesting that vitamin B12 and vitamin D deficiency, which affect homocysteine metabolism, may be associated with the development of DVT. In our study, we aimed to compare vitamin B12 and vitamin D levels in patients with DVT compared to the control group.
Materials and Methods: Between December 2015 and December 2020, 97 patients with DVT and 91 individuals without DVT were included in our routine. Serum vitamin B12 and vitamin D levels, clinical and other examination results of the patient and control groups were evaluated retrospectively from the hospital information system.
Results: There was no difference in demographic characteristics between the patient and control group included in the study. Serum vitamin D (19.64±8.68 vs 23.63±7.99, p<0.001) and vitamin B12 levels (252.94±101.17 vs 338.51±102.76, p<0.001) were found to be significantly lower in the group with DVT compared to the control group. In multivariate analysis, vitamin B12 level was found to be an independent predictor for DVT. (OR=0.991, 95% CI; 0.987-0.995, p<0.001).
Conclusions: Vitamin B12 and vitamin D levels are parameters that can be easily measured in the blood. In our study, both vitamin levels were found to be low in patients with DVT. It can be used as a possible simple indicator of the development of DVT, especially in patients with risk factors for DVT.

Kaynakça

  • 1) Ho WK, Hankey GJ, Lee CH, Eikelboom JW. Venous thromboembolism: diagnosis and management of deep venous thrombosis. MJA 2005;182:476-81.
  • 2) Heit JA. Venouse thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost 2005;3:1611-17.
  • 3) Holick MF. Vitamin D: a D-lightful health perspective. Nutr Rev 2008;66:182-94.
  • 4) Tare M, Emmett SJ, Coleman AH, Skordilis C, Eyles DW, Morley R,et al. Vitamin D insufficiency is associated with impaired vascular endothelial and smooth muscle function and hypertension in young rats. J. Physiol. (Lond.) 2011, 589, 4777-86.
  • 5) Akar N, Yılmaz E, Akar E, Avcu F, Cin Ş. Effect of plasminogen activator inhibtor-1 4G/5G polymorphism in Turkish deep vein thrombosis patients with and without FV 1691 GA. Thromb Res 2000; 97(4): 227-30.
  • 6) Korkmaz UTK, Ersoy S, Yüksel A, Çelik H, Uçaroğlu ER, Velioğlu Y, et al. Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study. Sao Paulo Med J. 2021; 139(3):279-84.
  • 7) den Heijer M, Willems HP, Blom HJ, Gerrits WB, Cattaneo M, Eichinger S, et al. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial. Blood. 2007 Jan 1;109(1):139-44.
  • 8) Aronow WS, Ahn C. Association between plazma homocys-teme and extracranial carotid arterial disease in older persons. Am J Cardiol 1997; 80:1216-18.
  • 9) Türkiye Endokrinoloji ve Metabolizma Derneği. Osteoporoz ve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu 2018: 119-27
  • 10) Mahan CE, Holdsworth MT, Welch SM, Borrego M, Spyropoulos AC. Deep-vein thrombosis: A United States cost model for a preventable and costly adverse event. Thromb Haemost 2011;106(09):405-15.
  • 11) Alagöl F, Shihadeh Y, Boztepe H, Tanakol R, Yarman S, Azizlerli H, et al. Sunlight exposure and vitamin D deficiency in Turkish women. Journal of endocrinological investigation. 2000;23(3):173-7. 12) Bozkaya G, Örmen M, Bilgili S, Aksit M. D vitamini için güneşten yeterince faydalanıyor muyuz? Türk Klinik Biyokimya Derg 2017; 15(1): 24-9.
  • 13) Bouillon R, Carmeilet G, Verlinden L, van Etten E, Verstuyf A, Luederer HF, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008;29:726-76.
  • 14) Khademvatani K, Seyyed-Mohammadzad MH, Akbari M, Rezaei Y, Eskandari R, Rostamzadeh A. The relationship between vitamin D status and idiopathic lower-extremity deep vein thrombosis. Int J Gen Med. 2014 Jun 19;7:303-9.
  • 15) Moscarelli L 1 , Zanazzi M, Bertoni E, Caroti L, Rosso G, Farsetti S, et al. Renin angiotensin system blockade and activated vitamin D as a means of preventing deep vein 127 thrombosis in renal transplant recipients. Clin Nephrol. 2011 May;75(5):440-50.
  • 16) Brøndum-Jacobsen P, Benn M, Tybjaerg-Hansen A, Nordestgaard BG. 25-Hydroxyvitamin D concentrations and risk of venous thromboembolism in the general population with 18,791 participants. J Thromb Haemost. 2013;11(3):423-31.
  • 17) Brodin E, Lerstad G, Grimnes G, Brækkan SK, Vik A, Brox J, Set al. Serum levels of vitamin D are not associated with future risk of venous thromboembolism. The Tromsø Study. Thromb Haemost. 2013;109(5):885-90.
  • 18) Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25OHD and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008;168:1174-80.
  • 19) Selhub J, Jacques PF, Wilson PW, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993;270(22):2693-8.
  • 20) McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol 1969;56:111-28.
  • 21) Tsai JC, Perrella MA, Yoshizumi M, Hsieh CM, Haber E, Schlegel R, et al. Promotion of vascular smooth muscle cell growth by homocysteine: a link to atherosclerosis. Proc Natl Acad Sci U S A 1994;91(14):6369-73.
  • 22) Aksoy M, Öç M, Aksoy Nur Ş. Bir Türk kohortunda plazma homosistein, folat ve B12 vitamini düzeylerinin koroner arter hastalığı risk faktörü olarak önemi. Türk Kardiyol Dem Arş 2000;28:475-80. 23) McIlroy SP, Dynan KB, Lawson JT, Patterson CC, Passmore AP. Moderately elevated plasma homocysteine, methylenetetrahydrofolate reductase genotype, and risk for stroke, vascular dementia, and Alzheimer disease in Northern Ireland. Stroke 2002;33(10):2351-6.
  • 24) Yang B, Fan S, Zhi X, Wang Y, Wang Y, Zheng Q, et al. Prevalence of hyperhomocysteinemia in China: a systematic review and meta-analysis. Nutrients 2014;7(1):74-90.
  • 25) Zhu M, Mao M, Lou X. Elevated homocysteine level and prognosis in patients with acute coronary syndrome: a meta-analysis. Biomarkers 2019;24(4):309-316.
  • 26) Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, et al. Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. Homocysteine lowering with folic acid and B vitamins in vascular disease. Nat Clin Pract Cardiovasc Med 2006;3:414–5.
  • 27) Rodgers GM, Conn MT. Homocysteine an atherogenic stimulus, reduces protein C activation by arterial and venous endothelial cells. Blood 1990;75:895-901.
  • 28) Ray JG. Meta-analysis of hyperhomocysteinemia as a risk factor for venous thromboembolic disease. Arch Intern Med 1998;158(19):2101-6.
  • 29) Karalezli A, Parlak ES, Kanbay A, Senturk A, Hasanoglu, HC. Homocysteine and Serum-Lipid Levels in Pulmonary Embolism. Clinical and Applied Thrombosis/Hemostasis 2011;17(6):186-89.

Derin Ven Trombozu Olan Hastalarda Vitamin B12 ve Vitamin D Düzeylerinin Değerlendirilmesi

Yıl 2022, Cilt: 19 Sayı: 1, 208 - 214, 28.04.2022
https://doi.org/10.35440/hutfd.1063465

Öz

Amaç: Derin ven trombozu (DVT) birçok nedene bağlı olarak ortaya çıkan önemli bir mortalite ve morbidite sebebidir. Otoimmun hastalıklar, maligniteler, geçirilmiş majör cerrahi girişimler, immobilite ve hiperhomosisteinemi metabolik hastalıklar DVT’ye yatkınlık oluştur. Homosistein metabolizmasını etkileyen vitamin B12 ve vitamin D eksikliğinin DVT gelişimi ile ilişkili olabileceği yönünde çalışmalar mevcuttur. Biz çalışmamızda DVT gelişmiş hastalarda, vitamin B12 ve vitamin D düzeylerinin kontrol grubuna göre kıyaslarak incelemeyi amaçladık.
Materyal Metod: Çalışmamıza Aralık 2015-Aralık 2020 tarihleri arasında DVT saptanan 97 hasta ve DVT’si olmayan 91 birey alındı. Hasta ve kontrol grubunun serum vitamin B12 ve vitamin D düzeyleri ile klinik ve diğer tetkik sonuçları hastane bilgi sisteminden retrospektif olarak değerlendirildi.
Bulgular: Çalışmaya alınan hasta ve kontrol grubu arasında demografik özellikler açısından fark saptanmadı. Serum vitamin D (19.64±8.68 vs 23.63±7.99, p<0.001) ve vitamin B12 düzeyleri (252.94±101.17 vs 338.51±102.76, p<0.001) DVT’si olan grupta, kontrol grubuna göre anlamlı olarak düşük saptandı. Çok değişkenli analizde, vitamin B12 düzeyinin DVT için bağımsız prediktör olduğu saptandı. (OR=0.991, %95 CI; 0.987-0.995, p<0.001).
Sonuç: Vitamin B12 ve vitamin D düzeyleri kanda kolaylıkla bakılabilen parametrelerdir. Çalışmamızda DVT olan hastalarda her iki vitamin düzeyi de düşük olarak bulundu. Özellikle DVT açısından risk faktörleri bulunan hastalarda, DVT gelişiminin olası basit bir göstergesi olarak kullanılabilir.

Kaynakça

  • 1) Ho WK, Hankey GJ, Lee CH, Eikelboom JW. Venous thromboembolism: diagnosis and management of deep venous thrombosis. MJA 2005;182:476-81.
  • 2) Heit JA. Venouse thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost 2005;3:1611-17.
  • 3) Holick MF. Vitamin D: a D-lightful health perspective. Nutr Rev 2008;66:182-94.
  • 4) Tare M, Emmett SJ, Coleman AH, Skordilis C, Eyles DW, Morley R,et al. Vitamin D insufficiency is associated with impaired vascular endothelial and smooth muscle function and hypertension in young rats. J. Physiol. (Lond.) 2011, 589, 4777-86.
  • 5) Akar N, Yılmaz E, Akar E, Avcu F, Cin Ş. Effect of plasminogen activator inhibtor-1 4G/5G polymorphism in Turkish deep vein thrombosis patients with and without FV 1691 GA. Thromb Res 2000; 97(4): 227-30.
  • 6) Korkmaz UTK, Ersoy S, Yüksel A, Çelik H, Uçaroğlu ER, Velioğlu Y, et al. Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study. Sao Paulo Med J. 2021; 139(3):279-84.
  • 7) den Heijer M, Willems HP, Blom HJ, Gerrits WB, Cattaneo M, Eichinger S, et al. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial. Blood. 2007 Jan 1;109(1):139-44.
  • 8) Aronow WS, Ahn C. Association between plazma homocys-teme and extracranial carotid arterial disease in older persons. Am J Cardiol 1997; 80:1216-18.
  • 9) Türkiye Endokrinoloji ve Metabolizma Derneği. Osteoporoz ve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu 2018: 119-27
  • 10) Mahan CE, Holdsworth MT, Welch SM, Borrego M, Spyropoulos AC. Deep-vein thrombosis: A United States cost model for a preventable and costly adverse event. Thromb Haemost 2011;106(09):405-15.
  • 11) Alagöl F, Shihadeh Y, Boztepe H, Tanakol R, Yarman S, Azizlerli H, et al. Sunlight exposure and vitamin D deficiency in Turkish women. Journal of endocrinological investigation. 2000;23(3):173-7. 12) Bozkaya G, Örmen M, Bilgili S, Aksit M. D vitamini için güneşten yeterince faydalanıyor muyuz? Türk Klinik Biyokimya Derg 2017; 15(1): 24-9.
  • 13) Bouillon R, Carmeilet G, Verlinden L, van Etten E, Verstuyf A, Luederer HF, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008;29:726-76.
  • 14) Khademvatani K, Seyyed-Mohammadzad MH, Akbari M, Rezaei Y, Eskandari R, Rostamzadeh A. The relationship between vitamin D status and idiopathic lower-extremity deep vein thrombosis. Int J Gen Med. 2014 Jun 19;7:303-9.
  • 15) Moscarelli L 1 , Zanazzi M, Bertoni E, Caroti L, Rosso G, Farsetti S, et al. Renin angiotensin system blockade and activated vitamin D as a means of preventing deep vein 127 thrombosis in renal transplant recipients. Clin Nephrol. 2011 May;75(5):440-50.
  • 16) Brøndum-Jacobsen P, Benn M, Tybjaerg-Hansen A, Nordestgaard BG. 25-Hydroxyvitamin D concentrations and risk of venous thromboembolism in the general population with 18,791 participants. J Thromb Haemost. 2013;11(3):423-31.
  • 17) Brodin E, Lerstad G, Grimnes G, Brækkan SK, Vik A, Brox J, Set al. Serum levels of vitamin D are not associated with future risk of venous thromboembolism. The Tromsø Study. Thromb Haemost. 2013;109(5):885-90.
  • 18) Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25OHD and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008;168:1174-80.
  • 19) Selhub J, Jacques PF, Wilson PW, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993;270(22):2693-8.
  • 20) McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol 1969;56:111-28.
  • 21) Tsai JC, Perrella MA, Yoshizumi M, Hsieh CM, Haber E, Schlegel R, et al. Promotion of vascular smooth muscle cell growth by homocysteine: a link to atherosclerosis. Proc Natl Acad Sci U S A 1994;91(14):6369-73.
  • 22) Aksoy M, Öç M, Aksoy Nur Ş. Bir Türk kohortunda plazma homosistein, folat ve B12 vitamini düzeylerinin koroner arter hastalığı risk faktörü olarak önemi. Türk Kardiyol Dem Arş 2000;28:475-80. 23) McIlroy SP, Dynan KB, Lawson JT, Patterson CC, Passmore AP. Moderately elevated plasma homocysteine, methylenetetrahydrofolate reductase genotype, and risk for stroke, vascular dementia, and Alzheimer disease in Northern Ireland. Stroke 2002;33(10):2351-6.
  • 24) Yang B, Fan S, Zhi X, Wang Y, Wang Y, Zheng Q, et al. Prevalence of hyperhomocysteinemia in China: a systematic review and meta-analysis. Nutrients 2014;7(1):74-90.
  • 25) Zhu M, Mao M, Lou X. Elevated homocysteine level and prognosis in patients with acute coronary syndrome: a meta-analysis. Biomarkers 2019;24(4):309-316.
  • 26) Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, et al. Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. Homocysteine lowering with folic acid and B vitamins in vascular disease. Nat Clin Pract Cardiovasc Med 2006;3:414–5.
  • 27) Rodgers GM, Conn MT. Homocysteine an atherogenic stimulus, reduces protein C activation by arterial and venous endothelial cells. Blood 1990;75:895-901.
  • 28) Ray JG. Meta-analysis of hyperhomocysteinemia as a risk factor for venous thromboembolic disease. Arch Intern Med 1998;158(19):2101-6.
  • 29) Karalezli A, Parlak ES, Kanbay A, Senturk A, Hasanoglu, HC. Homocysteine and Serum-Lipid Levels in Pulmonary Embolism. Clinical and Applied Thrombosis/Hemostasis 2011;17(6):186-89.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Serhat Çalışkan 0000-0002-0260-5463

Mehmet Atay 0000-0003-0011-190X

Ferit Böyük 0000-0003-2313-1495

Fatih Güngören 0000-0002-8053-017X

Yayımlanma Tarihi 28 Nisan 2022
Gönderilme Tarihi 27 Ocak 2022
Kabul Tarihi 18 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 19 Sayı: 1

Kaynak Göster

Vancouver Çalışkan S, Atay M, Böyük F, Güngören F. Derin Ven Trombozu Olan Hastalarda Vitamin B12 ve Vitamin D Düzeylerinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(1):208-14.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty