Pengaruh Suplementasi Vitamin D dan BMI terhadap LVEF dengan Pendekatan Generalized Additive Models Longitudinal

Cardiovascular diseases (CVD) are the leading cause of global mortality, with Left Ventricular Ejection Fraction (LVEF) being a key indicator of heart function. This study explores the impact of vitamin D supplementation and Body Mass Index (BMI) on LVEF using Generalized Additive Models (GAM) in longitudinal data from 47 elderly patients with hypovitaminosis D undergoing orthopedic surgery. LVEF was measured before surgery and at 1, 3, and 6 months post-intervention. GAM was employed to capture nonlinear relationships between variables with working correlation structures such as Independence, Exchangeable, Unstructured, and Autoregressive-1 (AR-1). The findings revealed a significant increase in vitamin D levels and LVEF following supplementation, while BMI remained relatively stable throughout the observation period. The best GAM model with AR-1 correlation structure achieved the lowest Quasi Information Criterion (QIC) score of 443.47, indicating a complex relationship between vitamin D and LVEF and a linear relationship between BMI and LVEF. Vitamin D demonstrated a significant nonlinear effect on LVEF improvement, whereas a 1-point increase in BMI raised LVEF by 0.291%. This study underscores the importance of vitamin D supplementation in enhancing heart function among elderly patients with hypovitaminosis D, supporting the development of evidence-based health policies