Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.
Endocr Pract. 2010 Jul-Aug;16(4):547-53. doi: 10.4158/EP09197.OR.
To study the vitamin D status and bone mineral density (BMD) in men infected with human immunodeficiency virus (HIV) in a tertiary care center from southern India.
We conducted a cross-sectional study of 35 HIV-infected men (between 20 and 50 years old) receiving highly active antiretroviral therapy (HAART) (group 1) in comparison with 35 age- and body mass index-matched HIV-positive antiretroviral therapy-naïve men (group 2) and 35 HIV-negative healthy control subjects (group 3).
A significantly greater proportion (P = .002) of patients (74%) in the HAART group had vitamin D deficiency (<20 ng/mL) in comparison with the other 2 groups (37% in each group). The mean intact parathyroid hormone level was higher (P<.001) and the mean duration of exposure to sunlight was lower (P = .001) in the HAART group than in the other 2 groups. By logistic regression analysis, HAART was found to be significantly associated with vitamin D deficiency. The BMD in the femoral neck was significantly lower in men with HIV infection who were receiving HAART in comparison with the other 2 groups (P = .006). On multivariate logistic regression, older age, low body mass index, and high parathyroid hormone levels emerged as factors significantly associated with decreased BMD at the femoral neck.
A significant proportion of patients receiving HAART had vitamin D deficiency. The secondary hyperparathyroidism probably due to vitamin D deficiency is an important contributing factor for the observed changes in BMD. Vitamin D deficiency noted in this group is probably multifactorial, and further research is needed to determine whether the effect of HAART on vitamin D metabolism is an additional causative factor and what benefit vitamin D supplementation might confer in these patients.
研究印度南部一家三级保健中心感染人类免疫缺陷病毒（HIV）的男性的维生素 D 状况和骨密度（BMD）。
我们对 35 名接受高效抗逆转录病毒治疗（HAART）的 HIV 感染男性（年龄在 20 至 50 岁之间）（组 1）进行了横断面研究，将其与 35 名年龄和体重指数匹配的未接受抗逆转录病毒治疗的 HIV 阳性男性（组 2）和 35 名 HIV 阴性健康对照者（组 3）进行了比较。
HAART 组中（74%）有较大比例（P =.002）的患者维生素 D 缺乏症（<20ng/ml），而其他 2 组的患者（每组 37%）维生素 D 缺乏症比例较低。HAART 组的完整甲状旁腺激素水平较高（P<.001），暴露于阳光下的时间较短（P =.001）。通过逻辑回归分析，发现 HAART 与维生素 D 缺乏显著相关。与其他 2 组相比，接受 HAART 的 HIV 感染男性的股骨颈 BMD 显著降低（P =.006）。在多变量逻辑回归分析中，年龄较大、低体重指数和甲状旁腺激素水平较高是与股骨颈 BMD 降低显著相关的因素。
接受 HAART 的患者中有相当大比例的人存在维生素 D 缺乏症。继发性甲状旁腺功能亢进症可能是由于维生素 D 缺乏所致，这是观察到的 BMD 变化的一个重要促成因素。该组患者中维生素 D 缺乏症可能是多因素的，需要进一步研究以确定 HAART 对维生素 D 代谢的影响是否是一个额外的致病因素，以及补充维生素 D 是否会对这些患者带来益处。
