Vitamin D and progression of carotid intima‐media thickness in HIV‐positive Canadians. Issue 2 (6th November 2017)

• Record Type: Journal Article
• Authors: Huff, H; Merchant, AT; Lonn, E; Pullenayegum, E; Smaill, F; Smieja, M
• Is Part Of: HIV medicine. Volume 19:Issue 2(2018)
• Page Start: 143
• Page End: 151
• Publication Date: 2017-11-06
• Subjects: carotid intima‐media thickness -- HIV -- vitamin D; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12563
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: Based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease (CVD), we hypothesized that in Canadian HIV‐positive adults, low 25‐hydroxyvitamin D (25(OH)D) concentration would be associated with increased subclinical vascular disease progression. Methods: We prospectively studied the relationship between baseline 25(OH)D and subsequent progression of carotid intima‐media thickness (CIMT) between 2002 and 2011, in the Canadian HIV Vascular Study using stored blood specimens. Results: Of the 128 participants, 89.1% were men, the mean age (standard deviation [SD]) was 46.5 (8.2) years, 93.8% were white, and 36.7% were current smokers. Mean (SD) annual CIMT follow‐up was 5.9 (1.8) years (maximum 8.5 years), providing approximately 750 patient‐years of follow‐up. Mean (SD) CIMT progression was 0.027 (0.030) mm/year. Mean (SD) 25(OH)D was 95.0 (46.9) nmol/L. Only 13.3% of participants were vitamin D deficient (25(OH)D < 50 nmol/L), whereas 61.7% had a 25(OH)D exceeding the sufficiency threshold (75 nmol/L). Vitamin D quartiles were inversely associated with body mass index (BMI) ( P = 0.034), total cholesterol to high‐density lipoprotein (HDL) cholesterol ratio ( P = 0.001) and parathyroid hormone concentration ( P = 0.003), but not efavirenz exposure ( P = 0.141). In linear regression analyses, baseline 25(OH)D as a continuous variable was inversely associated with CIMT progression in univariable ( P < 0.001) and multivariable ( P < 0.001) models. Conclusions: Baseline 25(OH)D was associated with CIMT progression in this relatively vitamin D replete, predominately white and male, Canadian HIV‐positive population. Future research needs to establish causality as this may warrant more targeted screening or supplementation.