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

Figures & data

Table 1. Characteristics During Study Period.

A. Changes over 24 Months in HIV-infected Subjects
Median (Q1, Q3)	All Subjects (N = 68)	P	Supplementation Dose (N = 42)	P	Standard Dose (N = 26)	P	P
Clinical and Laboratory Variables
BMI, kg/m^2	+1.1 (+0.1, +2.3)	<0.0001	+1.0 (-0.2, +2.9)	0.0001	+1.4 (+0.6, +1.9)	<0.0001	0.82
Waist-to-hip ratio	+0.01 (-0.04, +0.04)	0.80	+0.01 (-0.03, +0.05)	0.49	−0.00 (-0.06, +0.03)	0.53	0.43
CD4 count, cells/mm^3	+42 (-85, +159)	0.07	+57 (-77, +186)	0.07	+24 (-85, +158)	0.29	0.49
Systolic BP, mmHg	+4 (-5, +9)	0.12	+4 (-5, +10)	0.16	+3 (-5, +5)	0.39	0.60
LDL cholesterol, mg/dL	−6 (-19, +3)	0.003	−8 (-19, -1)	0.01	−5 (-18, +3)	0.12	0.57
HDL cholesterol, mg/dL	+2 (-4, +6)	0.35	0 (-4, +5)	1.00	+4 (-1, +7)	0.16	0.17
Triglycerides, mg/dL	+2.5 (-20, +19)	0.95	+8 (-26, +21)	0.79	−1 (-16, +17)	0.74	0.63
HOMA-IR	−0.01 (-0.89, +0.96)	0.64	+0.13 (-0.75, +1.56)	0.43	−0.06 (-1.27, +0.73)	0.80	0.42
25(OH)D, ng/mL	+18 (+9, +25)	<0.0001	+23 (+13, +33)	<0.0001	+3 (-4.5, +5.0)	<0.0001	0.004
Carotid IMT
CCA IMT, mm	−0.01 (-0.06, +0.02) (N = 67)	0.06	−0.01 (-0.05, +0.02) (N = 42)	0.44	−0.02 (-0.08, +0.02) (N = 25)	0.06	0.26
Bulb IMT, mm	−0.06 (-0.21, +0.02) (N = 53)	0.0006	−0.03 (-0.13, +0.04) (N = 35)	0.11	−0.19 (-0.27, -0.03) (N = 18)	0.0008	0.01
ICA IMT, mm	−0.04 (-0.17, +0.04) (N = 40)	0.10	−0.03 (-0.06, +0.03) (N = 26)	0.30	−0.09 (-0.19, +0.04) (N = 14)	0.15	0.34
B. Changes over 24 Months in Healthy Uninfected Subjects
Median (Q1, Q3)	All Subjects (N = 54)	P	Supplementation Dose(N = 33)	P	Standard Dose (N = 21)	P	P	P
Clinical and Laboratory Variables
BMI, kg/m^2	+1.4 (+0.0, +2.78)	<0.0001	+1.4 (+0.0, +2.8)	0.001	+1.5 (+0.0, +2.8)	0.01	0.79	0.95
Waist-to-hip ratio	+0.00 (-0.01, +0.03)	0.44	+0.00 (-0.01, +0.03)	0.70	+0.00 (-0.02, +0.02)	0.48	0.83	0.96
Systolic BP, mmHg	+6 (+2, +15)	<0.0001	+7 (+2, +14)	<0.0001	+6 (+1, +15)	0.005	0.70	0.01
LDL cholesterol, mg/dL	−2 (-19, +6)	0.15	−7 (-20, +1)	0.06	+0 (-12, +14)	0.90	0.13	0.43
HDL cholesterol, mg/dL	−2 (-5, +6)	0.44	−2 (-4, +6)	0.96	+0 (-7, +3)	0.35	0.51	0.23
Triglycerides, mg/dL	+0.(-12, +22)	0.38	+8 (-7, +27)	0.09	−4 (-15, +9)	0.46	0.06	0.61
HOMA-IR	+0.12 (-0.88, +1.27)	0.71	+0.33 (-0.97, +1.36)	0.73	+0.11 (-0.50, +0.52)	0.78	0.78	0.96
25(OH)D, ng/mL	+14 (+4, +23)	<0.0001	+21 (+12, +32)	<0.0001	+4 (+0, +12)	0.0003	<0.0001	0.17
Carotid IMT
CCA IMT, mm	−0.01 (-0.07, +0.02) (N = 52)	0.07	−0.01 (-0.07, +0.02) (N = 32)	0.22	−0.02 (-0.06, +0.02) (N = 20)	0.14	0.69	0.82
Bulb IMT, mm	−0.03 (-0.13, +0.04) (N = 44)	0.06	−0.03 (-0.12, +0.06) (N = 28)	0.33	−0.03 (-0.16, +0.04) (N = 16)	0.08	0.71	0.23
ICA IMT, mm	−0.03 (-0.15, +0.07) (N = 33)	0.07	−0.05 (-0.15, +0.07) (N = 20)	0.22	−0.02 (-0.22, +0.07) (N = 13)	0.27	0.88	0.97
C. Variables at 24 Months in HIV-infected Subjects
Median (Q1, Q3)	All Subjects (N = 68)		Supplementation Dose (N = 42)		Standard Dose (N = 26)		P
25(OH)D, ng/mL	37 (28, 44)		41 (31, 46)		32 (25, 38)		0.006
CCA IMT, mm	0.55 (0.51, 0.58)		0.56 (0.51, 0.58)		0.54 (0.49, 0.57)		0.39
Bulb IMT, mm	0.54 (0.47, 0.58)		0.55 (0.50, 0.60)		0.48 0.43, 0.56)		0.02
ICA IMT, mm	0.50 (0.39, 0.57)		0.51 (0.39, 0.57)		0.50 (0.40, 0.57)		0.98
D. Variables at 24 Months in Healthy Uninfected Subjects
Median (Q1, Q3)	All Subjects (N = 54)		Supplementation Dose (N = 33)		Standard Dose (N = 21)		P	P
25(OH)D, ng/mL	30 (23, 39)		38 (29, 51)		24 (20, 30)		0.0005	0.046
CCA IMT, mm	0.54 (0.51, 0.57)		0.55 (0.48, 0.58)		0.53 (0.51, 0.55)		0.36	0.17
Bulb IMT, mm	0.54 (0.42, 0.58)		0.39 (0.20, 0.54)		0.53 (0.43, 0.56)		0.49	0.52
ICA IMT, mm	0.49 (0.32, 0.54)		0.44 (0.32, 0.54)		0.50 (0.28, 0.54)		0.91	0.14

Notes.

# Supplementation dose = 60,000 IU/month (moderate dose) or 120,000 IU/month (high dose);

## Standard dose = 18,000 IU/month (control dose)

° P value for changes within group;

^† P value for differences in changes between the 2 dosing arms;

^‡ P value for differences in changes between combined HIV+ and combined healthy uninfected subjects; Q, quartile; BMI, body mass index; BP, blood pressure; LDL, low-density lipoprotein; HDL, high-density lipoprotein; HOMA-IR, homeostatic model assessment of insulin resistance; 25(OH)D, 25-hydroxyvitamin D; IMT, intima-media thickness; CCA, common carotid artery; ICA, internal carotid artery

Figure 1. Changes in carotid bulb IMT over the study period. These box and whisker plots show the distribution of changes after 24 months in the standard vs. supplementation arm for the HIV-infected subjects. Bottom and top edges of the box represent 25^th and 75^th percentiles, respectively, the center horizontal line is drawn at the median, and the bottom and top vertical lines (whiskers) extend to the 10^th and 90^th percentiles, respectively. Small circles outside of the vertical lines represent outlier data points. #P value for changes within group; ##P value for differences in changes between the 2 dosing arms

Figure 2. Relationship between change in 25(OH) and carotid bulb IMT. Scatter plots depict the bivariate relationship between changes in serum 25(OH)D concentrations and changes in carotid bulb IMT for (A). all HIV-subjects combined (R = 0.43; P = 0.001) and (B) shown by dosing arm separately (standard-dose arm: R = -0.05, P = 0.86; supplementation-dose arm: R = 0.47, P = 0.004). Increases in carotid bulb IMT were significantly correlated with increases in serum 25(OH)D concentrations, with this association driven by subjects in the supplementation arm. R, Spearman correlation coefficient. IMT, intima-media thickness; 25(OH)D, 25-hydroxyvitamin D