Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?

Conrado, Tereza; Miranda-Filho, Demócrito de Barros; Bandeira, Francisco

doi:10.1590/s0004-27302010000200006

Cited by 19 publications

(19 citation statements)

References 26 publications

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“…Survival increased substantially in patients with HIV/ aids after the introduction and advances of antiretroviral therapy (ART) (13), which is related to a more common development of chronic diseases, such as osteopenia and osteoporosis (14). Besides, HIV infection is also associated with high rates of fractures, including of vertebrae and hips (15).…”

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confidence: 99%

“…Besides, the population of HIV-positive patients face several other factors that contribute to increasing the prevalence of hypovitaminosis D, such as the use of ART and its potential effects on the metabolism of this vitamin (19), as well as infection with the HIV virus, which increases inflammatory cytokines, such as tumor necrosis factor α (TNFα), that inhibits renal hydroxylation of vitamin D and decreases its concentrations (13).…”

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confidence: 99%

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Risk factors associated with hypovitaminosis D in HIV/aids-infected adults

Canuto

Lima

et al. 2015

Arch. Endocrinol. Metab.

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Objective: To investigate risk factors associated with hypovitaminosis D in adult patients infected with HIV/aids, at a referral hospital in Maceió, Brazil. Subjects and methods: This cross-sectional study involved 125 patients evaluated from April to September 2013 by means of interviews, review of medical records, physical examination, and laboratory tests. The data were analyzed using the SPSS ® software, version 17.0; the prevalence of hypovitaminosis D and mean levels of vitamin D were determined. The association between hypovitaminosis D and the independent variables was assessed using the Chi-square or the Fisher's exact tests; mean vitamin D concentrations were analyzed using Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests. The level of significance was set at 5% across tests. Results: The prevalence of hypovitaminosis D was 24%, with a significant association with higher household income (p < 0.05). Higher vitamin D levels were associated with female gender (p < 0.001), no use of sunscreen (p < 0.05), and previous opportunistic infections (p < 0.01). Lower values were associated with the use of antiretroviral medication (p < 0.05), overweight and obesity (p < 0.01). Conclusion: Lower vitamin D concentrations were significantly associated with well-known risk factors for hypovitaminosis D: use of sunscreen, antiretroviral medication, overweight, and obesity. The prevalence of hypovitaminosis D in this study, considering values > 20 ng/mL or > 30 ng/mL as vitamin D sufficiency, was lower to that of previous studies with HIV-infected patients, a fact that might be related to the low latitude and high intensity of solar radiation of the location of the present study. Arch Endocrinol Metab. 2015;59(1):34-41

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confidence: 99%

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confidence: 99%

Risk factors associated with hypovitaminosis D in HIV/aids-infected adults

Canuto

Lima

et al. 2015

Arch. Endocrinol. Metab.

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“…The virus itself can diminish 25(OH)D levels by different mechanisms: (1) inhibitory effect of proinflammatory cytokines as tumor necrosis factor; (2) 25(OH)D uptake by macrophages and lymphocytes as the illness progresses; and (3) use of vitamin D for maturation and proliferation of lymphocytes [40,41].…”

Section: Factors Related To Vitamin D Deficiency In Patients With Hivmentioning

confidence: 99%

“…Its possible mechanisms include (1) renal dysfunction, (2) loss of phosphorus, and (3) increase in PTH. This last mechanism induces renal hydroxylation, resulting in increase of vitamin 1,25(OH) 2 D levels [40].…”

Section: Influence Of Antiretroviral Therapy On Vitamin D Metabolismmentioning

confidence: 99%

Vitamin D and HIV Infection

Jiménez

Lázaro

Aparicio

et al. 2015

Health of HIV Infected People

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“…Vitamin D insufficiency has now reached epidemic proportions, even in healthy individuals living in tropical regions. Recent data suggest association of hypovitaminosis D with metabolic syndrome, immune diseases, inflammatory bowel diseases, hypertension and diabetes (3)(4)(5).…”

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The protectiveness of the treatment of vitamin D insufficiency in the development of diabetes

Kurt¹,

Balta²,

Cakar³

et al. 2013

Arq Bras Endocrinol Metab

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W e read the article "High prevalence of vitamin D deficiency among newly diagnosed youth-onset diabetes mellitus in north India" written by Daga and cols. with interest (1). We find it is very valuable for the literature, as the study design was a prospective one. The authors showed that vitamin D levels were lower in patients with young-onset diabetes compared with healthy controls. They also showed the relationship between vitamin D deficiency and the development of diabetes.Vitamin D is a major regulator of mineral homeostasis by means of its action in the kidneys, intestines, bones, and parathyroid glands. Apart from its traditional actions related to calcium, vitamin D and its synthetic analogs are being increasingly recognized for their anti-proliferative, pro-differentiative, insulin-secretagogue, and immunomodulatory activities (2). Vitamin D insufficiency has now reached epidemic proportions, even in healthy individuals living in tropical regions. Recent data suggest association of hypovitaminosis D with metabolic syndrome, immune diseases, inflammatory bowel diseases, hypertension and diabetes (3-5).Accurate measurement of vitamin D levels is of great importance in such studies. Radioimmunoassay (RIA) was chosen in the study to measure vitamin D levels. The gold standard test for measuring vitamin D levels is liquid chromatography-tandem mass spectrometry (LC-MS/MS). In a study about the consistency of measurement methods of vitamin D, the accuracy of the RIA was determined as insufficient compared with LC-MS/MS, and HPLC was found to be adequate (6). We think that measuring the levels with HPLC instead of RIA could contribute to the study.In addition, while converting to the active form, vitamin D gets hydroxylated in the liver and kidneys. Therefore, liver diseases, renal failure, and use of anticonvulsant drugs may affect the levels of vitamin D (7). In the present study, there was no exclusion criteria or basal characteristics defined for these situations. It would be better if these conditions were excluded from the study.Finally, diabetes became a widespread, insidious, progressive epidemic disease, and has a high mortality and morbidity. We think that the best way to prevent this high mortality is to prevent diabetes from developing. Although many studies have been made about the protectiveness of the treatment of vitamin D insufficiency/deficiency in the development of diabetes, results is not clear yet. More comprehensive studies may be needed in this respect (8).

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Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?

Cited by 19 publications

References 26 publications

Risk factors associated with hypovitaminosis D in HIV/aids-infected adults

Risk factors associated with hypovitaminosis D in HIV/aids-infected adults

Vitamin D and HIV Infection

The protectiveness of the treatment of vitamin D insufficiency in the development of diabetes

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