From the *Emory University School of Medicine; †Children's Healthcare of Atlanta, Atlanta, GA; and ‡Case Western Reserve University and Rainbow Babies and Children's Hospital, Cleveland, OH.
Pediatr Infect Dis J. 2013 Nov;32(11):1224-9. doi: 10.1097/INF.0b013e318286c793.
In HIV-infected adults, we and others have shown that vitamin D deficiency is independently associated with increased carotid intima-media thickness (cIMT), a surrogate marker for cardiovascular disease (CVD). This study explored for the first time the relationship between vitamin D and CVD risk in HIV-infected youth.
This is a cross-sectional assessment of cIMT, inflammation, metabolic markers and vitamin D status in HIV-infected youth and healthy controls. We measured serum 25-hydroxyvitamin D (25(OH)D), fasting lipids, insulin, glucose, inflammatory markers and cIMT.
Thirty HIV-infected subjects and 31 controls were included. Among HIV-infected subjects, median age was 11 years (37% males; 73% black; similar to controls). HIV-infected subjects' mean (standard deviation) serum 25(OH)D was 24 (35) ng/mL; 70% had 25(OH)D<20 ng/mL (deficient), 23% between 20-30 ng/mL (insufficient) and 7%>30 ng/mL (sufficient); proportions were similar to controls (P=0.17). After adjusting for season, sex and race, there was no difference in serum 25(OH)D between groups (P=0.11). Serum 25(OH)D was not significantly correlated with cIMT, inflammatory markers or lipids. Serum 25(OH)D was negatively correlated with body mass index, insulin resistance, HIV duration, and cumulative use of antiretroviral therapy, non- and nucleoside reverse transcriptase inhibitors.
Most HIV-infected youth have vitamin D deficiency or insufficiency. Despite no direct association between serum 25(OH)D and cIMT, there were notable associations with some CVD risk factors, particularly inverse correlation with insulin resistance. Studies are needed to determine whether CVD risk, including insulin resistance, could be improved with vitamin D supplementation.
在 HIV 感染的成年人中，我们和其他人已经表明，维生素 D 缺乏与颈动脉内膜中层厚度（cIMT）增加独立相关，cIMT 是心血管疾病（CVD）的替代标志物。本研究首次探讨了 HIV 感染青少年中维生素 D 与 CVD 风险之间的关系。
这是对 HIV 感染青少年和健康对照者的 cIMT、炎症、代谢标志物和维生素 D 状态进行的横断面评估。我们测量了血清 25-羟维生素 D（25（OH）D）、空腹血脂、胰岛素、血糖、炎症标志物和 cIMT。
共纳入 30 例 HIV 感染患者和 31 例对照者。在 HIV 感染患者中，中位年龄为 11 岁（37%为男性；73%为黑人；与对照组相似）。HIV 感染患者血清 25（OH）D 的平均值（标准差）为 24（35）ng/mL；70%的患者 25（OH）D<20ng/mL（缺乏），23%在 20-30ng/mL 之间（不足），7%>30ng/mL（充足）；与对照组相比，这些比例无差异（P=0.17）。调整季节、性别和种族后，两组间血清 25（OH）D 无差异（P=0.11）。血清 25（OH）D 与 cIMT、炎症标志物或血脂无显著相关性。血清 25（OH）D 与体重指数、胰岛素抵抗、HIV 持续时间、以及非核苷和核苷酸逆转录酶抑制剂的累积使用呈负相关。
大多数 HIV 感染的青少年存在维生素 D 缺乏或不足。尽管血清 25（OH）D 与 cIMT 之间没有直接关联，但与一些 CVD 危险因素存在显著关联，尤其是与胰岛素抵抗呈负相关。需要研究来确定 CVD 风险，包括胰岛素抵抗，是否可以通过维生素 D 补充来改善。
