10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 6-8 November 2008, London, UK

ASSOCIATION OF SERUM VITAMIN D LEVELS AND TYPE 2 DIABETES IN HIV INFECTION IN THE MODENA COHORT

Antiviral Therapy 2008; 13(Suppl. 4):A30 (abstract no. P-10)

Z Szep¹, G Guaraldi², S Shah¹, G Orlando², N Squillace², V Rochira², B Madeo², C Diazzi², E Baraldi², GC Carani², R Esposito² and P Tebas^1
1University of Pennsylvania, Philadelphia, PA, USA; ²Università di Modena e Reggio Emilia, Modena, Italy

BACKGROUND: Type 2 diabetes mellitus (DM) and insulin resistance are common among individuals living with HIV. Low vitamin D levels increase the risk of DM and vitamin D supplementation has been shown to decrease the risk of type 2 DM in patients without HIV infection. We have shown that HIV-infected individuals have a high prevalence of vitamin D deficiency. The association between serum vitamin D levels and type 2 DM among HIV-infected individuals has not been evaluated. This study aimed to determine the association between 25 OH vitamin D (25[OH]VitD) levels and type 2 DM in patients with HIV infection.

METHODS: This was a retrospective cross-sectional study of patients enrolled in the Modena cohort, an ongoing, multicentre, prospective cohort of HIV-infected individuals in care at the Metabolic Clinic of the University of Modena and Reggio Emilia in Modena, Italy. Clinical and laboratory data including fasting glucose and serum 25(OH)VitD were obtained for all patients upon entry in the cohort. Individuals were classified as having type 2 DM if their fasting plasma glucose was ≥126 mg/dl. The 25(OH)VitD levels were compared between diabetic and non-diabetic patients. Multivariable logistic regression was used to further evaluate the relationship between 25(OH)VitD level and type 2 DM while controlling for traditional risk factors for DM.

RESULTS: There were 1,811 patients aged 14–76 years with available 25(OH)VitD and fasting glucose values. The mean 25(OH)VitD level was 18.98 ng/ml with 65.5% of patients having vitamin D deficiency (25[OH]VitD<20 ng/ml). In total, 6% of the patients had type 2 DM (see Table 1). Patients with adequate vitamin D levels (>20 ng/ml) were less likely to have type 2 DM (adjusted odds ratio 0.59 [95% CI 0.36–0.97]) after adjusting for age, body mass index and triglyceride levels.

CONCLUSIONS: Individuals with HIV and type 2 DM had significantly lower vitamin D levels in comparison with HIV infected individuals without type 2 DM. Patients with vitamin D deficiency were more likely to have type 2 DM in comparison with those with adequate vitamin D levels. Although causality cannot be inferred, vitamin D deficiency might be a modifiable risk factor for the development of type 2 DM among HIV-infected patients.

Download PDF of this abstract.

2008-11-06
P-10

Copyright © 2008 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.