Vitamin D Deficiency in HIV Infection: Not Only a Bone Disorder
Table 3
Carotid intima-media thickness (cIMT) and hypovitaminosis D in HIV patients.
Authors (year), journal
Nation
Patients
Results
Comments
Bajaj, Misra et al. (2012) Indian Indian Journal of Endocrinology and Metabolism
India
45 HIV-positive patients and 45 controls.
93.33% patients had 25(OH)D <30 ng/mL. 73.33% controls patients had 25(OH)D <30 ng/mL. cIMT 6 mm, 51.11% patients. cIMT 7 mm, 15.55% patients. cIMT 8 mm, 13.33% patients. cIMT >8 mm, 0% patients.
No significant difference in cIMT was proved between HIV-positive patients and controls (). A positive association was seen between CD4 levels and 25(OH)D.
149 HIV-positive patients (56 with carotid IMT), 34 controls.
5% patients had 25(OH)D <25 nmol/L. 46% patients had 25(OH)D <50 nmol/L. Mean icIMT in HIV-patients: 0.70 (0.55–0.91). Mean ccIMT in HIV-patients: 0.65 (0.55–0.75).
Authors observed a 10.62 higher probability of having cIMT above the median value in HIV-infected adults with 25(OH)D values below 30 ng/mL (). Vitamin D status was associated with CD4+ T-cell restoration after antiretroviral therapy but not with the inflammatory and endothelial activation markers, soluble TNF-α receptor 1 (sTNFR-1), and soluble intercellular adhesion molecule-1 (sICAM-1), associated with atherosclerosis and CVD development in the general population.
Choi et al. (2011) [45], Clinical Infectious Diseases
US
139 HIV-positive patients.
52% had 25(OH)D <30 ng/mL. Mean cIMT in patients with 25(OH)D >30 ng/dL: 0.87 mm. Mean cIMT in patients with 25(OH)D <30 ng/dL: 1.0 mm. Mean cIMT in patients with 25(OH)D <15 ng/dL: 1.1 mm.
An association between vitamin D insufficiency and cIMT, even after adjusting for age, sex, tobacco use, hypertension, and elevated cholesterol, was proved. The authors found that mean cIMT was 0.13 mm greater in vitamin D insufficient subjects than in normal subjects.
Eckard et al. (2013) [12], The Pediatric Infectious Disease Journal
US
30 HIV-positive patients, 31 controls.
72% patients versus 87% controls had 25(OH)D <20 ng/mL. 21% patients versus 13% controls had 25(OH)D <30 ng/mL.
After adjusting for season, sex, and race, there was no difference in serum 25(OH)D between groups (). Serum 25(OH)D was not significantly correlated with cIMT (). In HIV-infected group, 25(OH)D was negatively correlated with HOMA-IR, HIV duration, and cumulative duration of ART, NRTI, and NNRTI duration.
Portilla et al. (2014) [46], Journal of the International AIDS Society
Spain
89 HIV-positive patients (75 on ART).
80.8% had 25(OH)D <75 nmol/L. Bilateral mean cIMT in 25(OH)D deficient 0.63 ± 0.08 versus not deficient 0.56 ± 0.06 ().
High prevalence of 25(OH)D (80.9%) was found. Authors found no association between 25(OH)D insufficiency, inflammatory, or endothelial dysfunction markers and cIMT, whereas this was found between cIMT and patient age, impaired fasting glucose, and PI therapy length.
