Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection

Figures & data

Table 1 Characteristics of study participants by the presence of coronary calcificationa

Characteristic	Total	Coronary calcification		P-value
	(N = 846)	No (N = 608)	Yes (N = 238)
Age (years)	46 (41–51)	44 (39–49)	50 (46–54)	<0.0001
Male (%)	63.1	59.1	73.5	<0.001
Family history of CAD (%)	23.8	20.1	30.7	0.003
Cocaine use (%)	76.2	73.6	82.8	0.005
Cocaine use >15 years (%)	37.6	33.2	47.9	0.04
Cigarette smoking (%)	83.2	81.6	87.4	0.04
Cigarette smoking >15 years (%)	65.4	61.4	75.6	<0.0001
Alcohol use (%)	86.3	84.9	89.9	0.06
hsCRP ≥2 mg/dL (%)	45.7	44.1	50.0	0.12
hsCRP (mg/dL)	1.65 (0.6–4.7)	0.6 (0.2–1.6)	2.1 (0.6–5.0)	0.34
Serum 25-OH vitamin D (ng/mL)	18.0 (11.0–27.0)	18.0 (11.0–27.0)	18.0 (10.0–26.0)	0.06
Vitamin D deficiency (%)	18.7	16.9	23.1	0.038
Systolic BP (mmHg)	117 (108–128)	116 (107–125)	121 (111–132)	<0.0001
Diastolic BP (mmHg)	73 (66–81)	73 (66–81)	74 (68–83)	0.03
Fasting glucose (mg/dL)	85 (78–93)	85 (78–93)	86 (79–94)	0.38
Hypertension (%)	12.4	10.7	16.8	0.015
Diabetes (%)	4.0	3.5	5.5	0.18
BMI (kg/m^2)	25.1 (22.1–29.1)	25.0 (22.2–29.1)	25.4 (22.0–29.5)	0.64
Baseline CD4 (cells/mm^3)	368 (221–583)	374 (222–575)	347 (213–610)	0.85
Baseline viral loadb (copies/mL)	1,311 (202–32,950)	2,721(202–40,943)	462 (202–15,240)	0.06
Total cholesterol (mg/dL)	163 (140–191)	161 (139–186)	168 (141–199)	0.01
LDL-C (mg/dL)	85 (65–107)	84 (64–103)	90 (66–113)	0.02
HDL-C (mg/dL)	50 (39–61)	50 (40–61)	49 (36–62)	0.09
Triglycerides (mg/dL)	107 (75–155)	103 (72–147)	118 (84–178)	<0.0001
Year of enrollment (%)				0.19
2003–2005	12.4	13.2	10.5
2006–2007	12.5	13.0	11.3
2008–2009	34.8	32.6	40.3
2010–2011	37.8	40.2	37.8
Year of ART initiation				0.0007
Never initiated	20.8	23.2	14.7
Before 1996	11.0	9.2	15.6
1996–2003	30.3	28.8	34.0
2004–2007	22.8	21.9	25.2
2008–2010	15.1	16.9	10.5
Duration of NRTI use (months)	26.0 (2.9–26.0)	24.0 (0.9–66.0)	36.0 (7.9–93.0)	0.002
Duration of NNRTI use (months)	0 (0.0–14.0)	0.0 (0.0–12.0)	0.0 (0.0–24.0)	0.15
Duration of PI use (months)	12.0 (0.0–52.5)	7.9 (0.0–48.0)	15.0 (0.0–72.0)	0.005
Duration of ART use (months)	36.0 (6.9–86.0)	32.2 (4.9–80.0)	48.0 (15.0–115.1)	<0.0001
Framingham risk score	4.0 (2.0–7.0)	3.0 (2.0–6.0)	6.0 (4.0–10.0)	<0.0001
Framingham risk score <10.0 (%)	86.3	90.5	75.6	<0.0001

Notes:

a Median (interquartile range) for continuous variables, proportion (%) for categorical variables;

b HIV RNA quantification.

Abbreviations: 25-OH, 25-hydroxy; ART, antiretroviral therapy; BMI, body mass index (kg/m²); BP, blood pressure; CAD, coronary artery disease; HDL-C, high-density lipoprotein cholesterol; hsCRP, high-sensitivity C-reactive protein; LDL-C, low-density lipoprotein cholesterol; NNRTI, non-NRTI; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor.

Table 2 Demographic, laboratory, and clinical factors in relation to the presence of coronary calcification: logistic regression analysisa

Variable	Subclinical CAD
	Crude OR (95% CI)	Adjusted OR (95% CI)
Age	1.12 (1.09–1.15)	1.11 (1.08–1.14)
Sex
Female	1.00	1.00
Male	1.92 (1.39–2.68)	1.71 (1.18–2.49)
Family history of CAD
No	1.00	1.00
Yes	1.66 (1.18–2.33)	1.53 (1.05–2.23)
Cigarette smoking
Never	1.00
Ever	1.57 (1.01–2.42)
Alcohol use
No	1.00
Yes	1.59 (0.99–2.56)
Cocaine use
Never	1.00
Ever	1.72 (1.18–253)
Duration of cigarette smoking (years)	1.03 (1.01–1.04)
Duration of cocaine use (years)	1.03 (1.01–1.04)	1.02 (1.001–1.04)
hsCRP >2 mg/dL
No	1.00
Yes	1.27 (0.94–1.72)
Serum 25-OH vitamin D (ng/mL)
<10.0	1.00	1.00
10.0–19.9	0.68 (0.42–0.97)	0.53 (0.33–0.85)
20.0–29.9	0.64 (0.41–0.99)	0.40 (0.24–0.68)
≥30.0	0.83 (0.52–1.32)	0.61 (0.36–1.05)
Systolic BP (mmHg)	1.02 (1.01–1.03)
Diastolic BP (mmHg)	1.02 (1.01–1.03)
Fasting glucose	1.004 (0.999–1.009)
BMI (kg/m^2)	1.00 (0.98–1.03)
Baseline CD4 count
≥350 cells/mm^3	1.00
<350 cells/mm^3	1.14 (0.70–1.85)
Baseline viral loadb
≥400 copies/mL	1.00
<400 copies/mL	0.65 (0.39–1.07)
Total cholesterol (mg/dL)	1.005 (1.002–1.009)	1.006 (1.002–1.010)
LDL-C	1.005 (1.001–1.010)
HDL-C	0.993 (0.985–1.001)	0.989 (0.979–0.999)
Triglycerides (mg/dL)	1.003 (1.001–1.004)
Year of ART initiation
Never initiated	1.00
Before 1996	2.66 (1.53–4.64)
1996–2003	1.87 (1.18–2.94)
2004–2007	1.82 (1.13–2.94)
2008–2010	0.98 (0.55–1.73)
Year of enrollment
2003–2005	1.00
2006–2007	1.09 (0.58–2.05)
2008–2009	1.55 (0.93–2.59)
2010–2011	1.15 (0.69–1.91)
Duration of NRTI use (months)	1.005 (1.003–1.008)
Duration of NNRTI use (months)	1.004 (0.999–1.008)
Duration of PI use (months)	1.006 (1.003–1.009)	1.004 (1.001–1.007)
Duration of ART use (months)	1.006 (1.003–1.008)
Framingham risk score	1.015 (1.11–1.20)

Notes:

a subclinical CAD was coded as yes (1) or no (0);

b viral load, HIV RNA quantification.

Abbreviations: 25-OH, 25-hydroxy; ART, antiretroviral therapy; BMI, body mass index (kg/m²); BP, blood pressure; CAD, coronary artery disease; CI, confidence interval; HDL-C, high-density lipoprotein cholesterol; hsCRP, high-sensitivity C-reactive protein; LDL-C, low-density lipoprotein cholesterol; NNRTI, non-NRTI; NRTI, nucleoside reverse transcriptase inhibitor; OR, odds ratio; PI, protease inhibitor.