Low Vitamin D is associated with Coronary Atherosclerosis in Women with HIV

Abstract

Background Vitamin D deficiency is underdiagnosed and undertreated, especially among people living with HIV (PLWH). Recently, there has been an increased interest in the role of vitamin D in cardiovascular disease (CVD). While vitamin D deficiency has been associated with CVD in observational studies in the general population, there are limited data in PLWH. We therefore performed an analysis to assess the relationship of vitamin D and coronary atherosclerosis using coronary CT angiography (CCTA). Methods Women living with HIV (WLWH) without known CVD were included. Based on the median value of serum vitamin D levels, participants were dichotomized to either the <25 ng/ml (lower vitamin D group) or ≥25 ng/ml (higher vitamin D group). CCTA was used to assess plaque characteristics. Results Forty-three WLWH were included in the analyses (mean age 46 ±8 years, 56% African American, duration of HIV 15 ±6 years, 83% undetectable HIV viral load). WLWH in the lower vitamin D group ( n=22) had significantly higher numbers of segments with any coronary plaque (2.27 ±3.01 versus 0.38 ±0.97; P=0.02) and segments with non-calcified coronary plaque (1.41 ±1.82 versus 0.29 ±0.64; P=0.03) compared with WLWH in the higher vitamin D group ( n=21). After adjusting for Framingham CHD risk point score, body mass index, diabetes and race, the relationship remained significant. Conclusions Our study demonstrates a significant, independent relationship between lower vitamin D status and higher numbers of noncalcified coronary plaque segments in WLWH. Further studies are warranted to evaluate the effect of vitamin D on CVD in PLWH. Trial Registration Identifier: NCT00455793.

Serum biomarkers for arterial calcification in humans: A systematic review

“…In total, 30 studies performed analyses on a possible association between 25-hydroxyvitamin D (25(OH)D) and arterial calcifications ( Billington et al, 2020 ; Grønhøj et al, 2016 ; Tuersun et al, 2020 ; Zagura et al, 2011 ; Davaine et al, 2016 ; Liu et al, 2019 ; Pirro et al, 2013 ; Awan et al, 2010 ; Razavi et al, 2021 ; Bernandes et al, 2019 ; Kim et al, 2012 ; de Boer et al, 2009 ; Cheru et al, 2019 ; Doherty et al, 1997 ; El Mokadem et al, 2021 ; Eyyüpkoca et al, 2021 ; Ho et al, 2015 ; Kiani et al, 2013 ; Lai et al, 2013 ; Lee et al, 2016 ; Lim et al, 2012 ; Michos et al, 2009 ; Moradi and Foroutanfar, 2017 ; Nikolova et al, 2021 ; Rodrigues et al, 2021 ; Sajjadieh et al, 2020 ; Satilmis et al, 2015 ; Shikuma et al, 2012 ; Sung et al, 2016 ; Janus et al, 2021 ). Of these, ten studies found a negative association between 25(OH)D and arterial calcification ( Zagura et al, 2011 ; Pirro et al, 2013 ; de Boer et al, 2009 ; Doherty et al, 1997 ; El Mokadem et al, 2021 ; Eyyüpkoca et al, 2021 ; Lai et al, 2013 ; Lee et al, 2016 ; Moradi and Foroutanfar, 2017 ; Nikolova et al, 2021 ), two a positive association ( Zagura et al, 2011 ; Sung et al, 2016 ) and nineteen no significant association ( Billington et al, 2020 ; Grønhøj et al, 2016 ; Tuersun et al, 2020 ; Davaine et al, 2016 ; Liu et al, 2019 ; Awan et al, 2010 ; Razavi et al, 2021 ; …”

Biomarkers to predict cardiovascular disease in people living with HIV

“…Another area of research is the potential interplay between bone and renal function, inflammation and CVD. Cheru et al [31] explored associations between vitamin D levels and sCAD in a cohort of middle-aged women with HIV (WWH) in the USA. In this small study (n ¼ 43), WWH with lower vitamin D (<25 ng/ ml) had significantly higher circulating IL-6 and MCP-1 levels and higher total coronary plaques and noncalcified coronary plaques than those in the higher vitamin D group.…”

Prevalence and Predictors of Hypovitaminosis D in Ethiopian HIV-Infected Adults

“…For example, USA-70.3%, 1 New York City-21.2%, 2 South-Central United States -64%, 3 Spain -71.6%, 4 and Uganda -77%. 5 Hypovitaminosis D status is a known risk factor for bone fracture and low bone mineral density, 6,7 coronary artery disease, 8 atherosclerosis, [9][10][11] insulin resistance and type-2 diabetes 12 and neurocognitive impairment 13 in people living with HIV. Additionally, hypovitamin D status is also associated with tuberculosis.…”