title: Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients: a randomized placebo-controlled trial.
abstract: BACKGROUND
  Studies suggest that vitamin D deficiency is a risk factor for cardiovascular disease and diabetes. Vitamin D deficiency is prevalent in HIV patients but the effect of vitamin D supplementation on cardiovascular risk in this population is unknown.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled trial among 45 HIV-infected adults in Cleveland (OH, USA) on stable antiretroviral therapy with durable virological suppression and a baseline serum 25-hydroxyvitamin D level of ≤20 ng/ml. Participants were randomized 2:1 to vitamin D3 4,000 IU daily or placebo for 12 weeks. The primary outcome was a change in flow-mediated brachial artery dilation (FMD).
  
  
  RESULTS
  Baseline demographics were similar except for age (vitamin D versus placebo, mean ±sd 47 ±8 versus 40 ±10 years; P=0.009). Both groups had reduced FMD at baseline (median values 2.9% [IQR 1.6-4.8] for vitamin D versus 2.5% [IQR 1.7-6.4] for placebo; P=0.819). Despite an increase in the concentration of serum 25-hydroxyvitamin D from baseline to 12 weeks (5.0 ng/ml [IQR -0.9-7.4] versus -1.9 ng/ml [IQR -4.0-0.1] for vitamin D versus placebo, respectively; P=0.003), there was no difference in FMD change (0.55% [IQR -1.05-2.13] versus 0.29% [IQR -1.61-1.77]; P=0.748). Vitamin D supplementation was associated with a decrease in total and non-high-density lipoprotein cholesterol, and an increase in indices of insulin resistance.
  
  
  CONCLUSIONS
  Among HIV-infected individuals with vitamin D deficiency, supplementation with 4,000 IU vitamin D3 daily for 12 weeks modestly improved vitamin D status and cholesterol but worsened insulin resistance without change in endothelial function. The mechanisms of resistance to standard doses of vitamin D and the complex role of vitamin D in glucose metabolism in this population require further investigation.
authors.affiliation: University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Longenecker
authors.forename: Corrilynn O
authors.initials: CO
authors.lastname: Hileman
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Carman
authors.forename: Allison C
authors.initials: AC
authors.lastname: Ross
authors.forename: Shabnam
authors.initials: S
authors.lastname: Seydafkan
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Labbato
authors.forename: Norma
authors.initials: N
authors.lastname: Storer
authors.forename: Vin
authors.initials: V
authors.lastname: Tangpricha
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D015415:Biomarkers; D016022:Case-Control Studies; D019587:Dietary Supplements; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D014807:Vitamin D