Crutchley Rustin D, Gathe Joseph, Mayberry Carl, Trieu Angel, Abughosh Susan, Garey Kevin W
University of Houston, College of Pharmacy, Department of Clinical Sciences and Administration, 1441 Moursund Street, Houston, TX 77030, USA.
AIDS Res Hum Retroviruses. 2012 May;28(5):454-9. doi: 10.1089/aid.2011.0025. Epub 2011 Oct 19.
We evaluated the prevalence of serum 25-hydroxyvitamin D [25(OH)D] deficiency and the risk factors for vitamin D deficiency in HIV-infected patients in the South-Central United States. The study consisted of a cross-sectional assessment of vitamin D levels in HIV-infected patients receiving routine clinical care from a private practice in Houston, Texas (latitude 29°N). Vitamin D deficiency was defined as 25(OH)D less than 20 ng/ml (<50 nmol/liter). Two-hundred enrolled patients were surveyed with a vitamin D questionnaire to determine daily supplemental vitamin D intake, dietary vitamin D intake, and average sunlight exposure (minutes/day). Multivariate logistic regression analysis was used to determine significant risk factors for vitamin D deficiency. Median 25(OH)D was 15.5 ng/ml (interquartile range 10.9-24.6) for the total population (n=200). Approximately, two-thirds (64%) of patients had vitamin D deficiency and 20.5% had severe vitamin D deficiency [25(OH)D <10 ng/ml or <25 nmol/liter]. In univariate analysis, African-American race, current tobacco use, increased body mass index (BMI), lower serum calcium level, no supplemental vitamin D use, and low daily supplemental and total daily vitamin D intake were significantly associated with vitamin D deficiency. In multivariate analysis, African-American race [adjusted odds ratio (AOR) 3.53 (95% confidence interval (CI) 1.83-6.82)], higher BMI [AOR 1.07 (95% CI 1.002-1.139)], and low daily vitamin D supplemental intake [AOR 0.997 (95% CI 0.996-0.999)] were significantly associated with vitamin D deficiency. No HIV factors including antiretroviral class use were significantly associated with either vitamin D deficiency or severe vitamin D deficiency. Vitamin D deficiency and severe vitamin D deficiency were highly prevalent in this HIV population. In the HIV population, African-Americans or patients with a high BMI may benefit from vitamin D supplementation.
我们评估了美国中南部HIV感染患者血清25-羟基维生素D[25(OH)D]缺乏症的患病率以及维生素D缺乏的风险因素。该研究包括对在得克萨斯州休斯敦（北纬29°）一家私人诊所接受常规临床护理的HIV感染患者的维生素D水平进行横断面评估。维生素D缺乏定义为25(OH)D低于20 ng/ml（<50 nmol/升）。对200名入组患者进行了维生素D问卷调查，以确定每日维生素D补充摄入量、膳食维生素D摄入量和平均日照时间（分钟/天）。采用多因素逻辑回归分析来确定维生素D缺乏的显著风险因素。总体人群（n = 200）的25(OH)D中位数为15.5 ng/ml（四分位间距10.9 - 24.6）。约三分之二（64%）的患者存在维生素D缺乏，20.5%的患者存在严重维生素D缺乏[25(OH)D < 10 ng/ml或< 25 nmol/升]。在单因素分析中，非裔美国人种族、当前吸烟、体重指数（BMI）增加、血清钙水平降低、未使用维生素D补充剂以及每日维生素D补充摄入量和总每日维生素D摄入量低与维生素D缺乏显著相关。在多因素分析中，非裔美国人种族[调整后的优势比（AOR）3.53（95%置信区间（CI）1.83 - 6.82）]、较高的BMI[AOR 1.07（95% CI 1.002 - 1.139）]和低每日维生素D补充摄入量[AOR 0.997（95% CI 0.996 - 0.999）]与维生素D缺乏显著相关。没有包括抗逆转录病毒药物类别使用在内的HIV相关因素与维生素D缺乏或严重维生素D缺乏显著相关。维生素D缺乏和严重维生素D缺乏在该HIV人群中非常普遍。在HIV人群中，非裔美国人或BMI高的患者可能从维生素D补充中获益。
