Schtscherbyna Annie, Gouveia Carla, Pinheiro Maria Fernanda Miguens Castelar, Luiz Ronir Raggio, Farias Maria Lucia Fleiuss, Machado Elizabeth Stankiewicz
Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Laboratório Sérgio Franco, Rio de Janeiro, RJ, Brasil.
Mem Inst Oswaldo Cruz. 2016 Feb;111(2):128-33. doi: 10.1590/0074-02760150403.
The purpose was to determine the prevalence and related factors of vitamin D (VitD) insufficiency in adolescents and young adults with perinatally acquired human immunodeficiency virus. A cohort of 65 patients (17.6 ± 2 years) at the Federal University of Rio de Janeiro, Brazil, were examined for pubertal development, nutrition, serum parathormone and serum 25-hydroxyvitamin D [s25(OH)D]. s25(OH)D levels < 30 ng/mL (< 75 nmol/L) were defined as VitD insufficiency. CD4+ T-cell counts and viral load, history of worst clinical status, immunologic status as nadir, current immunologic status, and antiretroviral (ART) regimen were also evaluated as risk factors for VitD insufficiency. Mean s25(OH)D was 37.7 ± 13.9 ng/mL and 29.2% had VitD insufficiency. There was no difference between VitD status and gender, age, nutritional status, clinical and immunological classification, and type of ART. Only VitD consumption showed tendency of association with s25(OH)D (p = 0.064). Individuals analysed in summer/autumn season had a higher s25(OH)D compared to the ones analysed in winter/spring (42.6 ± 14.9 vs. 34.0 ± 11.9, p = 0.011). Although, the frequency of VitD insufficiency did not differ statistically between the groups (summer/autumn 17.9% vs. winter/spring 37.8%, p = 0.102), we suggest to monitor s25(OH)D in seropositive adolescents and young adults, especially during winter/spring months, even in sunny regions.
目的是确定围产期感染人类免疫缺陷病毒的青少年和青年中维生素D(VitD)不足的患病率及相关因素。对巴西里约热内卢联邦大学的65名患者(17.6±2岁)进行了青春期发育、营养状况、血清甲状旁腺激素和血清25-羟基维生素D[s25(OH)D]检测。s25(OH)D水平<30 ng/mL(<75 nmol/L)被定义为VitD不足。还评估了CD4+T细胞计数和病毒载量、最差临床状态病史、最低点免疫状态、当前免疫状态以及抗逆转录病毒(ART)治疗方案作为VitD不足的危险因素。平均s25(OH)D为37.7±13.9 ng/mL,29.2%的患者存在VitD不足。VitD状态与性别、年龄、营养状况、临床和免疫分类以及ART类型之间无差异。只有VitD摄入量显示出与s25(OH)D有相关趋势(p = 0.064)。在夏季/秋季分析的个体的s25(OH)D高于在冬季/春季分析的个体(42.6±14.9 vs. 34.0±11.9,p = 0.011)。尽管两组之间VitD不足的频率在统计学上没有差异(夏季/秋季为17.9%,冬季/春季为37.8%,p = 0.102),但我们建议对血清阳性的青少年和青年监测s25(OH)D,尤其是在冬季/春季月份,即使在阳光充足的地区。