Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients: A randomized placebo-controlled trial

Chris T. Longenecker, Corrilynn O. Hileman, Teresa L. Carman, Allison C. Ross, Shabnam Seydafkan, Todd T. Brown, Danielle E. Labbato, Norma Storer, Vin Tangpricha, Grace A. McComsey

Research output: Contribution to journalArticle

Abstract

Background: Studies suggest that vitamin D deficiency is a risk factor for cardiovascular disease and diabetes. Vitamin D deficiency is prevalent in HIV patients but the effect of vitamin D supplementation on cardiovascular risk in this population is unknown. Methods: We conducted a randomized, double-blind, placebo-controlled trial among 45 HIV-infected adults in Cleveland (OH, USA) on stable antiretroviral therapy with durable virological suppression and a baseline serum 25-hydroxyvitamin D level of ≤20 ng/ml. Participants were randomized 2:1 to vitamin D3 4,000 IU daily or placebo for 12 weeks. The primary outcome was a change in flow-mediated brachial artery dilation (FMD). Results: Baseline demographics were similar except for age (vitamin D versus placebo, mean ±sd 47 ±8 versus 40 ±10 years; P=0.009). Both groups had reduced FMD at baseline (median values 2.9% [IQR 1.6-4.8] for vitamin D versus 2.5% [IQR 1.7-6.4] for placebo; P=0.819). Despite an increase in the concentration of serum 25-hydroxyvitamin D from baseline to 12 weeks (5.0 ng/ ml [IQR -0.9-7.4] versus -1.9 ng/ml [IQR -4.0-0.1] for vitamin D versus placebo, respectively; P=0.003), there was no difference in FMD change (0.55% [IQR -1.05- 2.13] versus 0.29% [IQR -1.61-1.77]; P=0.748). Vitamin D supplementation was associated with a decrease in total and non-high-density lipoprotein cholesterol, and an increase in indices of insulin resistance. Conclusions: Among HIV-infected individuals with vitamin D deficiency, supplementation with 4,000 IU vitamin D3 daily for 12 weeks modestly improved vitamin D status and cholesterol but worsened insulin resistance without change in endothelial function. The mechanisms of resistance to standard doses of vitamin D and the complex role of vitamin D in glucose metabolism in this population require further investigation.

Original languageEnglish (US)
Pages (from-to)613-621
Number of pages9
JournalAntiviral therapy
Volume17
Issue number4
DOIs
StatePublished - 2012

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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    Longenecker, C. T., Hileman, C. O., Carman, T. L., Ross, A. C., Seydafkan, S., Brown, T. T., Labbato, D. E., Storer, N., Tangpricha, V., & McComsey, G. A. (2012). Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients: A randomized placebo-controlled trial. Antiviral therapy, 17(4), 613-621. https://doi.org/10.3851/IMP1983