title: Vitamin D deficiency is associated with type 2 diabetes mellitus in HIV infection.
abstract: BACKGROUND
  Metabolic complications, including type 2 diabetes mellitus and metabolic syndrome, are increasingly recognized among HIV-infected individuals. Low vitamin D levels increase the risk of type 2 diabetes mellitus, and vitamin D supplementation has been shown to decrease the risk of type 2 diabetes mellitus in patients without HIV infection.
  
  
  OBJECTIVE
  The primary objective was to determine whether vitamin D deficiency (serum 25-hyrdoxyvitamin D <20 ng/ml) was associated with type 2 diabetes mellitus among HIV-infected patients. Our secondary objective was to determine whether vitamin D deficiency was associated with metabolic syndrome in HIV.
  
  
  METHODS
  We conducted a cross-sectional study among participants enrolled in the prospective Modena (Italy) HIV Metabolic Clinic Cohort. Clinical and laboratory data, including history of type 2 diabetes mellitus, fasting blood glucose, components of metabolic syndrome, and 25-hydroxyvitamin D levels, were obtained for all participants.
  
  
  RESULTS
  After adjusting for vitamin D supplementation, sex, age, body mass index, and hepatitis C virus co-infection, vitamin D deficiency was associated with type 2 diabetes mellitus [adjusted odds ratio (OR) 1.85; 95% confidence interval (CI) 1.03-3.32; P = 0.038]. The association between vitamin D deficiency and metabolic syndrome was not significant after adjusting for vitamin D supplementation, sex, age and body mass index (adjusted OR 1.32; 95% CI 1.00-1.75; P = 0.053).
  
  
  CONCLUSIONS
  Our study demonstrates an association between vitamin D deficiency and type 2 diabetes mellitus. Clinical trials are needed to better characterize the association between vitamin D deficiency and type 2 diabetes mellitus in HIV infection and to evaluate whether vitamin D is able to prevent or delay the onset of type 2 diabetes mellitus.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, USA. zsofia.szep@uphs.upenn.edu
authors.forename: Zsofia
authors.initials: Z
authors.lastname: Szep
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Samir S
authors.initials: SS
authors.lastname: Shah
authors.forename: Vincent
authors.initials: V
authors.lastname: Lo Re
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Gabriella
authors.initials: G
authors.lastname: Orlando
authors.forename: Federica
authors.initials: F
authors.lastname: Carli
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rochira
authors.forename: Pablo
authors.initials: P
authors.lastname: Tebas
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D