Relationship Between Vitamin D Deficiency, LDH, Troponin, and BNP Levels in Patients with Cardiovascular Disease

Author(s): Haider Hatem Mohsen, Usama Hamed Ramadhan
Date: 09/10/2026
doi: https://doi.org/10.5281/zenodo.8425890

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Abstract

Cardiovascular diseases (CVDs) constitute the primary cause of morbidity and mortality. Recent studies 
demonstrate the relationship between vitamin D deficiency and increase of cardiac biomarkers (Troponin 
I, BNP) and metabolic enzymes (LDH) in CVD pathogenesis and prognosis. Objective to assess the 
correlations and profile of vitamin D deficiency, LDH, Troponin I, and BNP in the patients with diagnosed 
CVDs in comparison with healthy controls. A case control study included 100 patients with CVDs and 
100 gender- and age-matched controls. Serum levels of Troponin I, BNP, 25-hydroxyvitamin D, and LDH 
were assessed using the appropriate validated immunoassays and enzymatic methods. Mann-Whitney U 
test was used to compare the studied groups; Spearman's rank correlation and stratified analysis were 
performed to identify the associations between biomarkers. Higher levels of Troponin I (median: 280.5 
vs. 0.9 ng/L; p<0.001), BNP (median: 96.5 vs. 10.0 pg/mL; p<0.001), and LDH (median: 369.0 vs. 171.5 
U/L; p<0.001) were detected in CVD patients in comparison with controls. The patients demonstrated 
lower levels of vitamin D (median: 17.1 vs. 30.35 ng/mL; p<0.001). Stratified analysis indicated that the 
CVD patients with severe vitamin D deficiency (<15 ng/mL) demonstrated significantly higher median 
levels of Troponin I, BNP, and LDH in comparison with the CVD patients with relatively preserved 
vitamin D levels (p<0.05 for all parameters). Vitamin D deficiency is highly correlated with CVD and the 
severity of cardiac injury and metabolic stress markers. These results indicate the importance of vitamin 
D status in the cardiovascular risk stratification.

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