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

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Vitamin D
Randomized Controlled Trials
Placebos
HIV
Vitamin D Deficiency
Cholecalciferol
Insulin Resistance
Brachial Artery
Serum
Population
Dilatation
Cardiovascular Diseases
Cholesterol
Demography
Glucose

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients : A randomized placebo-controlled trial. / Longenecker, Chris T.; Hileman, Corrilynn O.; Carman, Teresa L.; Ross, Allison C.; Seydafkan, Shabnam; Brown, Todd T; Labbato, Danielle E.; Storer, Norma; Tangpricha, Vin; McComsey, Grace A.

In: Antiviral Therapy, Vol. 17, No. 4, 2012, p. 613-621.

Research output: Contribution to journalArticle

Longenecker, CT, Hileman, CO, Carman, TL, Ross, AC, Seydafkan, S, Brown, TT, Labbato, DE, Storer, N, Tangpricha, V & McComsey, GA 2012, 'Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients: A randomized placebo-controlled trial', Antiviral Therapy, vol. 17, no. 4, pp. 613-621. https://doi.org/10.3851/IMP1983
Longenecker, Chris T. ; Hileman, Corrilynn O. ; Carman, Teresa L. ; Ross, Allison C. ; Seydafkan, Shabnam ; Brown, Todd T ; Labbato, Danielle E. ; Storer, Norma ; Tangpricha, Vin ; McComsey, Grace A. / Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients : A randomized placebo-controlled trial. In: Antiviral Therapy. 2012 ; Vol. 17, No. 4. pp. 613-621.
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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.",
author = "Longenecker, {Chris T.} and Hileman, {Corrilynn O.} and Carman, {Teresa L.} and Ross, {Allison C.} and Shabnam Seydafkan and Brown, {Todd T} and Labbato, {Danielle E.} and Norma Storer and Vin Tangpricha and McComsey, {Grace A.}",
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T1 - Vitamin D supplementation and endothelial function in vitamin D deficient HIV-infected patients

T2 - A randomized placebo-controlled trial

AU - Longenecker, Chris T.

AU - Hileman, Corrilynn O.

AU - Carman, Teresa L.

AU - Ross, Allison C.

AU - Seydafkan, Shabnam

AU - Brown, Todd T

AU - Labbato, Danielle E.

AU - Storer, Norma

AU - Tangpricha, Vin

AU - McComsey, Grace A.

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

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