Key result
Vitamin D insufficiency is linked to subclinical atherosclerosis in HIV patients.
Why the study?
Vitamin D insufficiency is linked to faster atherosclerosis progression and elevated cardiovascular risk, but limited data exist in people living with HIV.
Is vitamin D insufficiency associated with subclinical atherosclerosis in HIV-infected patients on stable antiretroviral therapy?
Cross-Sectional (n=188)
Is vitamin D insufficiency associated with subclinical atherosclerosis in HIV-infected patients on stable antiretroviral therapy?
p-value: p=<0.001
Vitamin D insufficiency is independently associated with subclinical atherosclerosis in HIV-infected patients on stable antiretroviral therapy, suggesting a potential target for cardiovascular risk reduction.
Should not yet change vitamin D management in HIV; leaves open causal role in atherosclerosis.
Objectives: Vitamin D insufficiency has been associated with faster progression of atherosclerosis and increased cardiovascular disease risk, but limited data are available in HIV-infected people. So, we examined potential correlation between vitamin D status and atherosclerosis in people living with HIV.Methods: A cross-sectional study was performed including adult HIV-infected patients on stable antiretroviral therapy, aged 40–60 years, and with a recent carotid ultrasonography. Subclinical atherosclerosis was defined as a carotid intima-media thickness (IMT) ≥0.9 mm at any site. Patients with diabetes mellitus or atherosclerotic cardiovascular disease were excluded.Results: On the whole, 188 patients were enrolled: 86.2% were men and the mean age was 49.1 years. The mean CD4 T lymphocyte count was 567 cells/mm3, 176 (93.6%) had plasma HIV RNA <20 copies/mL, 51.1% were smoker, 29.2% had hypertension, 27.7% metabolic syndrome, and 44.7% LDL cholesterol >150 mg/dL. The mean serum concentration of vitamin D was 35.2 ng/mL, and 84 (44.6%) patients had a vitamin D insufficiency (<30 ng/mL). Subclinical atherosclerosis was reported in 105 (55.8%) and the mean vitamin D concentration was significantly lower among patients with subclinical atherosclerosis than among those without (18.2 vs 41.3 ng/mL, p < 0.001). Moreover, the multivariate linear regression analysis adjusted by confounding factors showed an independent association between subclinical atherosclerosis and vitamin D insufficiency, age >50 years, smoking, hypertension, metabolic syndrome, higher BMI, higher LDL cholesterol, longer duration of HIV infection, lower nadir CD4 cell count, and longer exposure to boosted protease inhibitors.Conclusion: In our study, vitamin D insufficiency is significantly associated with subclinical atherosclerosis, so its role in HIV-associated cardiovascular disease should be further evaluated as a possible target for intervention.
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Calza et al. (2019) conducted a cross-sectional in HIV-1 infection (n=188). Vitamin D insufficiency vs. Vitamin D sufficiency was evaluated on Subclinical atherosclerosis (carotid intima-media thickness ≥0.9 mm) (p=<0.001). Vitamin D insufficiency was independently associated with subclinical atherosclerosis in HIV-infected patients, who had significantly lower mean vitamin D levels (18.2 vs 41.3 ng/mL; p<0.001).
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