Gangcuangco Louie Mar A, Chow Dominic C, Liang Chin-Yuan, Nakamoto Beau K, Umaki Tracie M, Kallianpur Kalpana J, Shikuma Cecilia M
University of Hawai'i, Honolulu, HI, USA.
Hawaii J Med Public Health. 2013 Jun;72(6):197-201.
HIV-infected individuals are at increased risk for several metabolic diseases, including low 25-hydroxyvitamin D [25(OH)D]. Data on the prevalence and risk factors for low 25(OH)D in HIV patients living in the tropics is scarce. Patients ≥ 40 years old on stable antiretroviral therapy were enrolled from March 2009 to July 2011 in Hawai'i (latitude 21° North). Chemiluminescent immunoassay (DiaSorin) was used to determine plasma 25(OH)D levels. Patients were grouped by whether 25(OH)D was collected in summer (May 1 - September 30) or winter (October 1 - April 30). Of 158 patients enrolled, 88 (56%) and 70 (44%) were enrolled in winter and summer, respectively. There were 57.6% Caucasians and 88% men. Over-all median (quartile1, quartile3) age was 51 (46, 57) years and median 25(OH)D was 32.4 (24.0, 41.0) ng/ml. Forty-three percent (n=68) had 25(OH)D<30.0 ng/ml. Median 25(OH)D levels were 29.6 (22.0, 38.0) ng/ml in winter and 36.9 (25.0, 44.5) ng/ml in summer (P = .01). Median body mass index (BMI) of winter patients was significantly higher (P = .03). By simple linear regression, log-transformed 25(OH)D was significantly associated with winter visit (β = -.0737, P = .01), ethnicity (Caucasian versus non-Caucasian, β = .1194, P < .01), BMI (β = -.0111, P < .01) and current use of zidovudine (β = -.1233, P = .03). In multiple linear regression, only Caucasian ethnicity (β = .1004, P < .01) and BMI (β = -.0078, P = .02) retained statistical significance. Seasonal variation in 25(OH)D was observed but the significance of winter visit was not preserved in the final multivariate model. Ethnicity and BMI were better predictors of 25(OH)D levels than season in the tropics.
感染HIV的个体患几种代谢性疾病的风险增加，包括25-羟基维生素D[25(OH)D]水平低。关于热带地区HIV患者中25(OH)D水平低的患病率和危险因素的数据很少。2009年3月至2011年7月，在夏威夷（北纬21°）招募了年龄≥40岁且接受稳定抗逆转录病毒治疗的患者。采用化学发光免疫分析法（DiaSorin）测定血浆25(OH)D水平。根据25(OH)D是在夏季（5月1日至9月30日）还是冬季（10月1日至4月30日）采集，将患者分组。在158名入组患者中，分别有88名（56%）和70名（44%）在冬季和夏季入组。其中57.6%为白种人，88%为男性。总体年龄中位数（四分位数1，四分位数3）为51（46，57）岁，25(OH)D中位数为32.4（24.0，41.0）ng/ml。43%（n = 68）的患者25(OH)D<30.0 ng/ml。冬季25(OH)D水平中位数为29.6（22.0，38.0）ng/ml，夏季为36.9（25.0，44.5）ng/ml（P = 0.01）。冬季患者的体重指数（BMI）中位数显著更高（P = 0.03）。通过简单线性回归分析，经对数转换的25(OH)D与冬季就诊（β = -0.0737，P = 0.01）、种族（白种人与非白种人，β = 0.1194，P < 0.01）、BMI（β = -0.0111，P < 0.01）以及当前使用齐多夫定（β = -0.1233，P = 0.03）显著相关。在多元线性回归分析中，只有白种人种族（β = 0.1004，P < 0.01）和BMI（β = -0.0078，P = 0.02）保留了统计学意义。观察到25(OH)D存在季节性变化，但在最终的多变量模型中，冬季就诊的显著性未保留。在热带地区，种族和BMI比季节更能预测25(OH)D水平。
