Evidence map›Paper›PMID 32822412›Full record

ArticlePloS one2020

Evaluating Vitamin D levels in Rheumatic Heart Disease patients and matched controls: A case-control study from Nepal.

Lene Thorup, Sophie Amalie Hamann, Ashish Tripathee, Bhagawan Koirala, Bishal Gyawali, Dinesh Neupane, Cleonice C Mota, Per Kallestrup, Vibeke E Hjortdal

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 4 countries.

Lene ThorupDepartment of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark.ORCID 0000-0002-5208-8353
Sophie Amalie HamannDepartment of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark.
Ashish TripatheeWestern Regional Hospital, Pokhara Academy of Health Sciences, Pokhara, Nepal.
Bhagawan KoiralaDepartment of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu, Nepal.
Bishal GyawaliDepartment of Public Health, Section of Global Health, University of Copenhagen, Copenhagen, Denmark.
Dinesh NeupaneNepal Development Society, Chitwan, Nepal.
Cleonice C MotaFaculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Per KallestrupDepartment of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark.
Vibeke E HjortdalDepartment of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Aarhus University · DKJohns Hopkins University · USUniversidade Federal de Minas Gerais · BRUniversity of Copenhagen · DKWestern Regional Hospital · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnosis and treatment for Rheumatic Heart Disease (RHD) is inaccessible for many of the 33 million people in low and middle income countries living with this disease. More knowledge about risk factors and pathophysiologic mechanisms involved is needed in order to prevent disease and optimize treatment. This study investigated risk factors in a Nepalese population, with a special focus on Vitamin D deficiency because of its immunomodulatory effects.

methodsNinety-nine patients with confirmed RHD diagnosis and 97 matched, cardiac-healthy controls selected by echocardiography were recruited from hospitals in the Central and Western region of Nepal. Serum 25(OH)D concentrations were assessed using dried blood spots and anthropometric values measured to evaluate nutritional status. Conditional logistic regression analysis was used to define association between vitamin D deficiency and RHD.

resultsThe mean age of RHD patients was 31 years (range 9-70) and for healthy controls 32 years (range 9-65), with a 4:1 female to male ratio. Vitamin D levels were lower than expected in both RDH and controls. RHD patients had lower vitamin D levels than controls with a mean s-25(OH)D concentration of 39 nmol/l (range 8.7-89.4) compared with controls 45 nmol/l (range 14.5-86.7) (p-value = 0.02). People with Vitamin D insufficiency had a higher risk (OR = 2.59; 95% CI: 1.04-6.50) of also having RHD compared to people with Vitamin D concentrations >50 nmol/l. Body mass index was significantly lower in RHD patients (22.6; 95% CI, 21.5-23.2) compared to controls (24.2; 95% CI, 23.3-25.1).

conclusionRHD patients in Nepal have lower Vitamin D levels and overall poor nutritional status compared to the non-RHD controls. Longitudinal studies are needed to explore the causality between RHD and vitamin D level. Future research is also recommended among Nepali general population to confirm the low level of vitamin D as reported in our control group.

Indexed as

AdolescentAdultAgedCase-Control StudiesChildDemographyFemaleHumansMaleMiddle AgedNepalRheumatic Heart DiseaseRisk FactorsVitamin DVitamin D Deficiency25-hydroxyvitamin DVitamin D

Identifiers

PMID32822412
PMCPMC7444549
OpenAlexW3081366306

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.