背景:维生素D缺乏和/或不足(维生素D缺乏症)与包括自身免疫性疾病在内的多种疾病有关,1型糖尿病;心血管疾病;肿瘤;肥胖;胰岛素抵抗,和2型糖尿病。这个问题在南欧国家很常见,特别是老年人和机构机构。在艾滋病毒感染者中,维生素D缺乏症与结核病等各种并发症有关,甲状旁腺功能亢进,骨量丢失,过早的动脉粥样硬化,和全身性动脉高血压,免疫功能恶化,疾病进展和总死亡率。
目的:这项研究的目的是检查希腊HIV感染患者队列中维生素D缺乏症的患病率和原因,因素,以及与之相关的可能的并发症。
方法:本研究包括所有在我们的HIV病房就诊5个月的患者。维生素D状态,医学样本,在基线时进行实验室检查;随访患者3年,并记录HIV相关并发症.在随访期间没有患者接受维生素D补充剂。
结果:维生素D缺乏症很常见,83.7%的患者显示水平低于30ng/dl,55.4%低于20ng/dl。经过多变量分析,年龄和治疗持续时间是维生素D水平低的唯一显著因素.随访期间,26例患者共出现34例HIV相关并发症,最常见的是肺炎囊虫肺炎(PCP)。低维生素D与总体并发症呈正相关,PCP以及消瘦综合征。
结论:总体而言,我们的研究表明,维生素D缺乏症在HIV感染者中很常见,应该尽快治疗,以保护这些患者免受严重的HIV相关并发症,如PCP或消瘦综合征.
BACKGROUND: Vitamin D deficiency and/or insufficiency (hypovitaminosis D) has been associated with several disorders including autoimmune diseases, like type 1 diabetes mellitus; cardiovascular diseases; neoplasms; obesity; insulin resistance, and type 2 diabetes mellitus. This problem is common in southern European countries, especially in elderly and institutionalized persons. In HIV-infected individuals, hypovitaminosis D has been correlated with various complications like tuberculosis, hyperparathyroidism, bone mass loss, premature atherosclerosis, and systemic arterial hypertension, deterioration of immune function, progression of the disease and overall mortality.
OBJECTIVE: The objective of this study was to examine the prevalence and causes of hypovitaminosis D in a cohort of Greek HIV-infected patients, the factors, and possible complications associated with it.
METHODS: All patients attending our HIV unit for a period of 5 months were included in this study. Vitamin D status, medical anamnes, and laboratory tests were obtained at baseline; patients were followed for 3 years and HIV-related complications were noted. No patient received vitamin D supplementation during the follow-up period.
RESULTS: Hypovitaminosis D was common, with 83.7% of the patients showing levels below 30ng/dl and 55.4% below 20ng/dl. After multivariable analysis, age and duration of treatment were the only significant factors for low vitamin D levels. During follow-up, 26 patients exhibited a total of 34 HIV-related complications, the most common being pneumonocystis jiroveci pneumonia (PCP). Hypovitaminosis D showed a positive correlation with overall complications, PCP as well as wasting syndrome.
CONCLUSIONS: Overall, our study shows that hypovitaminosis D is common in HIV-infected individuals and should probably be treated as soon as possible to protect these patients from serious HIVrelated complications like PCP or wasting syndrome.