Introduction: Nutritional deficiencies have been described in patients with pulmonary arterial hypertension (PAH), such as iron and vitamin D. However, an extensive description of vitamin and mineral status is lacking, and until now, there are no data on dietary intake in PAH- patients.
Methods: In total, 37 patients were included (six males, 31 females; of 47.92 ± 16.25 years old). Blood analyses were carried out in a routine setting of an ISO15189:2012 accredited medical laboratory. Nutritional intake was analyzed using a food frequency questionnaire (HELIUS). Quality of life (QoL) was assessed by the SF-36 questionnaire.
Results: We could confirm previously observed deficiencies of iron and vitamin D in our study population. In addition, we could observe a functional vitamin B12 deficiency in some of the patients (29%), which coincided with an increased expression of methylmalonic acid. Sixty per cent of the patients had a low vitamin K1 status (<0.8 nmol/L), from which less than half used vitamin K antagonists. Finally, 40% had selenium levels <100 μg/L, and we could observe an association with reduced QoL in these patients. The dietary intake of sugar was >25 g in 87% of the patients, and fluid intake was >1,500 mL in 78% of the patients. Sodium intake was <1,800 mg in the majority (56%) of the patients. Sugar and fluid intake were linearly related.
Conclusion: Besides the known deficiencies in iron and vitamin D levels, we observed in a subset of patients signs of vitamin B12, vitamin K1 and selenium deficiencies. There is room for improving dietary intake. Future research will demonstrate the clinical importance and will reveal the effect of nutritional interventions.
Sponsor: This investigator-sponsored study was financially supported by Janssen-Cilag B.V.
C. T. Kwant, Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands F. A. L. van der Horst, Department of Clinical Chemistry, Reinier Haga Medica Diagnostic Center, Delft, The Netherlands F. S. de Man, H. J. Bogaart, A. Vonk Noordegraaf, Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands