The role of vitamin D in the progression of chronic heart failure: association with mineral metabolism and pro-inflammatory cytokines

Authors

DOI:

https://doi.org/10.14739/2310-1210.2026.4.338428

Keywords:

chronic heart failure, vitamin D, parathormone, cytokines, VEGF, endotelin-1

Abstract

The aim of this study was to assess the role of vitamin D in chronic heart failure (CHF) progression and to analyze its association with mineral metabolism parameters and pro-inflammatory cytokines.

Materials and methods. The study included 219 CHF patients aged 30–89 years: 123 with NYHA class I–II (mean age 60.4 ± 1.0) and 96 with class III–IV (mean age 62.9 ± 1.0). Serum levels of vitamin D, calcium, phosphorus, magnesium, parathyroid hormone (PTH), endothelin-1, FGF-23, IL-6, IL-18, TNF-α, and VEGF-A were analyzed.

Results. Vitamin D deficiency worsened progressively with CHF severity. Compared to controls, vitamin D levels were reduced by 31 % (p < 0.001) in NYHA I–II and 2.4-fold (p < 0.001) in NYHA III–IV compared with controls. In advanced CHF, calcium and magnesium decreased by 5.5 % (p < 0.001) and 8.8 % (p < 0.001), respectively, while phosphorus changes were nonsignificant between NYHA I–II and III–IV. PTH, endothelin-1 and FGF-23 rose significantly: in NYHA I–II by 51.5 %, 54.2 %, and 10.8 % (p < 0.001), and in NYHA III–IV by 62.3 %, 94.5 %, and 17.0 % (p < 0.001). Inflammatory cytokines also increased. IL-6 rose by 75.0 % (p < 0.001) in NYHA I–II and 2.4-fold (p < 0.001) in NYHA III–IV. IL-18 increased by 75.2 % and 95.0 % (p < 0.001), while TNF-α rose by 46.0 % and 62.0 % (p < 0.001) in respective groups. VEGF-A levels showed the most pronounced change, increasing 4.2-fold (p < 0.001) in NYHA I–II and 8.6-fold (p < 0.001) in NYHA III–IV. Correlation analysis revealed a strong positive association between vitamin D and ejection fraction, and negative correlations with FGF-23 and inflammatory cytokines. These findings suggest that CHF progression appears to involve both metabolic and immunological mechanisms, and that vitamin D deficiency is associated with aggravation of these processes.

Conclusions. Vitamin D deficiency in CHF worsens with advancing NYHA class and is closely linked to increased levels of FGF-23, PTH, and pro-inflammatory cytokines. Its positive correlation with ejection fraction highlights vitamin D’s regulatory role beyond bone metabolism, extending to cardiovascular and immune systems. Correction of vitamin D deficiency may therefore hold therapeutic potential for patients with reduced ejection fraction.

Author Biography

F. Ch. Almammadov, Azerbaijan Medical University, Baku

MD, PhD student, Department of Family Medicine

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Published

2026-07-08

How to Cite

1.
Almammadov FC. The role of vitamin D in the progression of chronic heart failure: association with mineral metabolism and pro-inflammatory cytokines. Zaporozhye Medical Journal [Internet]. 2026Jul.8 [cited 2026Jul.13];28(4):316-22. Available from: https://zmj.zsmu.edu.ua/article/view/338428

Issue

Vol. 28 No. 4 (2026)

Section

Original research

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Copyright (c) 2025 F. Ch. Almammadov

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