Effects of vitamin D supplementation on carotid intima-media thickness in HIV-infected youth

Continued Interest and Controversy: Vitamin D in HIV

“…Longenecker et al performed a 12-week trial of 4000IU vitamin D 3 daily versus placebo among 45 vitamin D-deficient HIV patients and found no change in endothelial function as assessed by flow-mediated brachial artery dilation [149]. Recently, Eckard et al investigated the impact of 24 months of standard vs high dose VitD 3 supplementation in HIV-infected and uninfected youth, and found that standard dose VitD 3 (18,000 IU monthly) supplementation resulted in a statistically significant decrease in carotid bulb IMT among HIV-infected participants (p=0.03) compared with higher VitD 3 [150].…”

Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents

“…An analysis of over 41,000 adults demonstrated highly significant inverse associations of 25hydroxyvitamin D (25OHD) levels and the prevalence of type 2 diabetes mellitus, systemic hypertension, dyslipidemias, and peripheral vascular disease 5 . In a group of HIV-infected youth, standard doses of 25OHD supplementation (18,000 IU/month vitamin D3) were shown to decrease carotid bulb intimal medial thickness, a marker for subclinical atherosclerosis 6 . Various mechanisms have been proposed to explain 25OHD contributions to the development of cardiovascular disorders, in both HIV and general populations, including inflammation, alterations in insulin sensitivity, and inhibition of the reninangiotensin-aldosterone axis.…”

“…Various mechanisms have been proposed to explain 25OHD contributions to the development of cardiovascular disorders, in both HIV and general populations, including inflammation, alterations in insulin sensitivity, and inhibition of the reninangiotensin-aldosterone axis. 6,7 Derangements in other factors affecting bone mineralization, such as parathyroid hormone (PTH) and phosphate, have also been associated with subclinical myocellular damage. In pediatric patients with chronic renal failure, higher cardiac troponin T (cTnT), a marker of myocardial injury, was associated with reduced PTH and elevated phosphate 8 .…”

Noncommunicable diseases in adolescents with perinatally acquired HIV-1 infection in high-income and low-income settings

“…In addition, statins have lipid-lowering effects in adults [29–30] and are beginning to be evaluated in children with one recent Phase I/II trial finding improvements in lipid parameters among children with ART-associated dyslipidemia with atorvastatin use but also possible toxicity concerns in younger children [31**]. Vitamin D supplementation was also evaluated as a potential mediator of AVD risk in HIV-infected children but contrary to expectations may increase carotid intima-media thickness and be detrimental to vascular health [32].…”

“…This may reflect varying degrees of pre-existing vitamin D deficiency or repletion in different study populations. It should be borne in mind that excessive vitamin D supplementation may be detrimental to vascular health [32]. Calcium supplementation has not been evaluated among HIV-infected adolescents to improve BMD.…”