Vitamin D insufficiency and subclinical atherosclerosis in non‐diabetic males living with HIV

Abstract

Introduction Vitamin D insufficiency (VDI) has been associated with increased cardiovascular risk in the non‐HIV population. This study evaluates the relationship among serum 25‐hydroxyvitamin D [25(OH)D] levels, cardiovascular risk factors, adipokines, antiviral therapy (ART) and subclinical atherosclerosis in HIV‐infected males. Methods A cross‐sectional study in ambulatory care was made in non‐diabetic patients living with HIV. VDI was defined as 25(OH)D serum levels <75 nmol/L. Fasting lipids, glucose, inflammatory markers (tumour necrosis factor‐α, interleukin‐6, high‐sensitivity C‐reactive protein) and endothelial markers (plasminogen activator inhibitor‐1, or PAI‐I) were measured. The common carotid artery intima‐media thickness (C‐IMT) was determined. A multivariate logistic regression analysis was made to identify factors associated with the presence of VDI, while multivariate linear regression analysis was used to identify factors associated with common C‐IMT. Results Eighty‐nine patients were included (age 42±8 years), 18.9% were in CDC (US Centers for Disease Control and Prevention) stage C and 75 were on ART. VDI was associated with ART exposure, sedentary lifestyle, higher triglycerides levels and PAI‐I. In univariate analysis, VDI was associated with greater common C‐IMT. The multivariate linear regression model, adjusted by confounding factors, revealed an independent association between common C‐IMT and patient age, time of exposure to protease inhibitors (PIs) and impaired fasting glucose (IFG). In contrast, there were no independent associations between common C‐IMT and VDI or inflammatory and endothelial markers. Conclusions VDI was not independently associated with subclinical atherosclerosis in non‐diabetic males living with HIV. Older age, a longer exposure to PIs, and IFG were independent factors associated with common C‐IMT in this population.

Keywords

• atherosclerosis
• vitamin D insufficiency
• carotid intima media thickness
• HIV
• antiretroviral treatment
• adipokines