Vitamin D insufficiency and subclinical atherosclerosis in non-diabetic males living with HIV.
BACKGROUND
Vitamin D insufficiency (VDI) has been associated with increased cardiovascular risk in the non-HIV population. This study evaluates the relationship among serum 25-hydroxyvitamin D [25(OH)D] levels, cardiovascular risk factors, adipokines, antiviral therapy (ART) and subclinical atherosclerosis in HIV-infected males.


METHODS
A cross-sectional study in ambulatory care was made in non-diabetic patients living with HIV. VDI was defined as 25(OH)D serum levels <75 nmol/L. Fasting lipids, glucose, inflammatory markers (tumour necrosis factor-α, interleukin-6, high-sensitivity C-reactive protein) and endothelial markers (plasminogen activator inhibitor-1, or PAI-I) were measured. The common carotid artery intima-media thickness (C-IMT) was determined. A multivariate logistic regression analysis was made to identify factors associated with the presence of VDI, while multivariate linear regression analysis was used to identify factors associated with common C-IMT.


RESULTS
Eighty-nine patients were included (age 42 ± 8 years), 18.9% were in CDC (US Centers for Disease Control and Prevention) stage C and 75 were on ART. VDI was associated with ART exposure, sedentary lifestyle, higher triglycerides levels and PAI-I. In univariate analysis, VDI was associated with greater common C-IMT. The multivariate linear regression model, adjusted by confounding factors, revealed an independent association between common C-IMT and patient age, time of exposure to protease inhibitors (PIs) and impaired fasting glucose (IFG). In contrast, there were no independent associations between common C-IMT and VDI or inflammatory and endothelial markers.


CONCLUSIONS
VDI was not independently associated with subclinical atherosclerosis in non-diabetic males living with HIV. Older age, a longer exposure to PIs, and IFG were independent factors associated with common C-IMT in this population.
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain.
Joaquín
J
Portilla
Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain; Endocrinology and Nutrition Department, Alicante University General Hospital-FISABIO, Alicante, Spain; omoreno@umh.es.
Oscar
O
Moreno-Pérez
Neurology Department, San Carlos Clinic Hospital, Madrid, Spain.
Carmen
C
Serna-Candel
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain.
Corina
C
Escoín
Hormone Laboratory, Alicante University General Hospital-FISABIO, Alicante, Spain.
Rocio
R
Alfayate
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain.
Sergio
S
Reus
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain.
Esperanza
E
Merino
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain.
Vicente
V
Boix
Infectious Diseases Unit, Alicante University General Hospital-FISABIO, Alicante, Spain.
Livia
L
Giner
Preventive Medicine Department, Alicante University General Hospital-FISABIO, Alicante, Spain.
José
J
Sánchez-Payá
Clinical Medicine Department, Miguel Hernández University, Campus of San Juan, San Juan de Alicante, Alicante, Spain; Endocrinology and Nutrition Department, Alicante University General Hospital-FISABIO, Alicante, Spain.
Antonio
A
Picó
D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D050197:Atherosclerosis / Q000209:etiology*; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*
D001786:Blood Glucose; D015850:Interleukin-6; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1; D014409:Tumor Necrosis Factor-alpha; D014807:Vitamin D; D002097:C-Reactive Protein; C104450:25-hydroxyvitamin D
HIV; adipokines; antiretroviral treatment; atherosclerosis; carotid intima media thickness; vitamin D insufficiency