Hoffman Risa M, Lake Jordan E, Wilhalme Holly M, Tseng Chi-Hong, Currier Judith S
1 Department of Medicine, Division of Infectious Diseases, and Center for Clinical AIDS Research and Education (CARE), David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California.
2 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California.
AIDS Res Hum Retroviruses. 2016 Mar;32(3):247-54. doi: 10.1089/aid.2015.0200. Epub 2015 Nov 16.
Data on vitamin D insufficiency as a cause of inflammation and metabolic dysfunction in HIV-infected individuals are conflicting. We examined the relationships between levels of 25-hydroxyvitamin D [25(OH)D] and biomarkers of inflammation and metabolism in stored blood samples from a prospective trial of vitamin D repletion. Blood samples from HIV-infected individuals on antiretroviral therapy (ART) with HIV-1 RNA <200 copies/ml enrolled in a prospective study were analyzed for 25(OH)D levels, a broad panel of cytokines, highly sensitive C-reactive protein, D-dimer, adiponectin, leptin, and insulin. Correlations between markers and 25(OH)D levels were determined. The Wilcoxon Rank Sum test was used to compare markers between individuals 25(OH)D insufficient and sufficient at baseline and before and after repletion among those who were insufficient and repleted to ≥30 ng/ml after 12 weeks. Of 106 subjects with stored plasma [66 with 25(OH)D <30 ng/ml and 40 ≥ 30 ng/ml], the median age was 50, the CD4 count was 515 cells/mm(3), 94% were male, and the median baseline 25(OH)D was 27 ng/ml. Higher 25(OH)D levels were associated with lower tumor necrosis factor (TNF)-α (r = -0.20, p = 0.04) and higher adiponectin levels (r = 0.30, p = 0.002). Following successful repletion to 25(OH)D ≥30 ng/ml there were no significant changes in inflammatory or metabolic parameters. Our study found associations between low 25(OH)D levels and TNF-α and adiponectin. Repletion did not result in changes in markers of inflammation or metabolism. These data support continued study of the relationship between vitamin D, inflammation, and metabolism in treated HIV infection.
关于维生素D缺乏作为HIV感染者炎症和代谢功能障碍病因的数据存在矛盾。我们在一项维生素D补充的前瞻性试验中，研究了储存血样中25-羟基维生素D[25(OH)D]水平与炎症和代谢生物标志物之间的关系。对参加一项前瞻性研究且接受抗逆转录病毒治疗（ART）、HIV-1 RNA<200拷贝/ml的HIV感染者的血样进行分析，检测25(OH)D水平、一组广泛的细胞因子、高敏C反应蛋白、D-二聚体、脂联素、瘦素和胰岛素。确定标志物与25(OH)D水平之间的相关性。采用Wilcoxon秩和检验比较基线时以及12周后25(OH)D不足者补充至≥30 ng/ml前后，25(OH)D不足者和充足者之间的标志物。在106例有储存血浆的受试者中（66例25(OH)D<30 ng/ml，40例≥30 ng/ml），中位年龄为50岁，CD4细胞计数为515个/mm³，94%为男性，基线25(OH)D中位数为27 ng/ml。较高的25(OH)D水平与较低的肿瘤坏死因子（TNF）-α相关（r = -0.20，p = 0.04），与较高的脂联素水平相关（r = 0.30，p = 0.002）。成功补充至25(OH)D≥30 ng/ml后，炎症或代谢参数无显著变化。我们的研究发现低25(OH)D水平与TNF-α和脂联素之间存在关联。补充并未导致炎症或代谢标志物的变化。这些数据支持继续研究维生素D、炎症和代谢在接受治疗的HIV感染中的关系。
