title: Intact parathyroid hormone levels are associated with increased carotid intima media thickness in HIV infected patients.
abstract: OBJECTIVE
  Preliminary evidence suggests that intact parathyroid hormone (iPTH) and bone mineral abnormalities may contribute to the development of vascular disease and are associated with reduced survival in the general population. Whether iPTH is associated with subclinical atherosclerosis in HIV-infected individuals has not been elucidated.
  
  
  METHODS
  Cross-sectional study of 470 consecutive HIV-infected patients in whom we measured carotid intima-media thickness (cIMT), and collected demographical, clinical and laboratory data. High-cIMT was defined as a mean IMT above the 75th percentile for the study cohort. Parametric, non-parametric tests and logistic regression analyses were used to compare patients' characteristics between low- and high-cIMT and to test the association between high-cIMT and log-transformed iPTH.
  
  
  RESULTS
  Of the 470 patients, 130 had high-cIMT. High-cIMT subjects were older and more likely to be male and have a history of cardiovascular disease. Glucose, lipid and iPTH levels were lower among low-cIMT subjects (p < 0.05). Unadjusted and multivariable adjusted analyses demonstrated an independent association between high-cIMT and iPTH (fully adjusted OR: 1.74; 95%CI: 1.08-2.79; p = 0.021). Bootstrap and sensitivity analyses confirmed these findings.
  
  
  CONCLUSIONS
  Elevated iPTH was associated with subclinical atherosclerosis in HIV-infected subjects. Of note this association was statistically significant even for iPTH values within the range of normality. The existence of a causal relationship between iPTH and atherosclerosis needs to be fully explored in future investigations.
authors.affiliation: Nephrology and Dialysis Unit, Azienda Ospedaliera S. Anna, Como, Italy; Department of Health Sciences, University of Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellasi
authors.affiliation: Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada. Electronic address: raggi@ualberta.ca.
authors.forename: Paolo
authors.initials: P
authors.lastname: Raggi
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rochira
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Stentarelli
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zona
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Lattanzi
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Carli
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mussini
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D050197:Atherosclerosis / Q000503:physiopathology; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000097:blood* / Q000150:complications; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications; D012307:Risk Factors
chemical_list: D010281:Parathyroid Hormone
keywords: Atherosclerosis; HIV; Intact PTH