The impact of psychosocial factors on secondary hyperparathyroidism and vitamin D deficiency in adults with congenital heart disease-the CHD-HYPER study.

BACKGROUND

Secondary hyperparathyroidism (sHPT) and vitamin D deficiency are common comorbidities in adults with congenital heart disease (ACHD), but the relationship with lifestyle factors, and psychosocial health remains poorly understood.

METHODS

This single-center cross-sectional study included 662 ACHD patients (mean age: 39.3 years; 47% female) and analyzed their clinical, psychosocial, and lifestyle data, including laboratory parameters, quality of life (QoL), and mental health metrics. Predictors of sHPT and vitamin D deficiency were evaluated using multivariate regression models.

FINDINGS: sHPT was observed in 13% and vitamin D deficiency in 43.4% of patients. In the multivariate analysis, infrequent alcohol consumption (p < 0.05), reduced QoL (p < 0.05), fewer headaches (p < 0.05), higher NYHA class (p < 0.05), elevated NT-proBNP levels (p < 0.05), metabolic syndrome (p < 0.05), and lower exercise frequency (p < 0.05) were independent predictors of sHPT. Reduced QoL (p < 0.05), less frequent alcohol consumption (p < 0.01), lower exercise frequency (p < 0.05) and shorter exercise duration (p < 0.01), as well as not living in a partnership (p < 0.01) were independent predictors of vitamin D deficiency.

CONCLUSION

This study highlights the multifactorial etiology of sHPT and vitamin D deficiency in ACHD, underscoring the roles of disease severity, lifestyle, and psychosocial factors. sHPT appears to be closely associated with advanced cardiac disease and heart failure and may serve as a marker of increased disease burden. Accordingly, assessment of sHPT may contribute to a more comprehensive risk stratification in ACHD. Further studies are needed to determine whether targeted interventions improve clinical outcomes.