title: Association between 25-OH vitamin D and insulin is independent of lipoatrophy in HIV.
abstract: OBJECTIVE
  Vitamin D deficiency (VDD) is prevalent in HIV, and following antiretroviral therapy (ART), increased rates of lipoatrophy and metabolic abnormalities are described. We investigated the relationships between 25-hydroxyvitamin D [25(OH)D] and other metabolic parameters in a group of HIV patients with and without lipoatrophy to examine whether lipoatrophy could explain the high prevalence of VDD and metabolic abnormalities.
  
  
  BACKGROUND
  Vitamin D receptors are expressed in adipose tissue implicating vitamin D, through paracrine/autocrine mechanism, in exerting effects on fat metabolism. HIV patients frequently suffer from VDD, and those treated with thymidine analogues frequently suffer from lipoatrophy so we investigated whether lipoatrophy could explain these associations.
  
  
  METHODS
  Cross-sectional study of HIV-infected male patients (n = 107; 39 with lipoatrophy) from the West Australian cohort with measurements of 25(OH)D, adiponectin, insulin, lipids and leg fat as a percentage of mass.
  
  
  RESULTS
  Reduced 25(OH)D levels were common and significantly associated with higher serum insulin in the entire cohort (P = 0·006), but there was no difference in 25(OH)D between untreated and antiretroviral-treated patients with or without lipoatrophy. Treated patients with lipoatrophy were more likely to take thymidine analogue therapy, were older and on therapy longer than treated patients without lipoatrophy. Adiponectin levels did not correlate with 25(OH)D, but lipoatrophic-treated patients had lower levels of adiponectin compared with nonlipoatrophic-treated patients.
  
  
  CONCLUSIONS
  Lower 25(OH)D is associated with higher serum insulin but not lipoatrophy or hypoadiponectinemia in HIV-infected patients. The association between VDD and insulin resistance is likely to be mediated by independent mechanisms.
authors.affiliation: Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Hammond
authors.forename: E
authors.initials: E
authors.lastname: McKinnon
authors.forename: P
authors.initials: P
authors.lastname: Glendenning
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.forename: S
authors.initials: S
authors.lastname: Mallal
authors.forename: E
authors.initials: E
authors.lastname: Phillips
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008060:Lipodystrophy / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D019380:Anti-HIV Agents; D007328:Insulin; D014807:Vitamin D; C104450:25-hydroxyvitamin D