Associations between vitamin D metabolites, antiretroviral therapy and bone mineral density in people with HIV

ABSTRACTGlucocorticoid (GC) administration is an effective therapy commonly used in the treatment of autoimmune and inflammatory diseases. However, the use of GC can give rise to serious complications. The main detrimental side effect of GC therapy is significant bone loss, resulting in glucocorticoid-induced osteoporosis (GIOP).We performed a systematic review and network meta-analysis (NMA) to evaluate whether the use of calcium supplementation, with or without vitamin D, vitamin D metabolites and vitamin D analogues is capable of increasing bone mineral density (BMD) at the lumbar spine, femoral neck, and hip in adult patients undergoing glucocorticoid therapies compared to no treatment.

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Sarcoidosis and calcium homeostasis disturbances—Do we know where we stand?

Chronic Respiratory Disease ◽

10.1177/1479973119878713 ◽

2019 ◽

Vol 16 ◽

pp. 147997311987871 ◽

Cited By ~ 2

Author(s):

Łukasz Gwadera ◽

Adam Jerzy Białas ◽

Mikołaj Aleksander Iwański ◽

Paweł Górski ◽

Wojciech Jerzy Piotrowski

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Calcium Homeostasis ◽

Calcium Metabolism ◽

Vitamin D Supplementation ◽

Vitamin D Metabolites ◽

Activated Macrophages ◽

Mineral Density ◽

Metabolism Disorder

The majority of cases involving hypercalcemia in the setting of sarcoidosis are explained by the overproduction of calcitriol by activated macrophages. Vitamin D takes part in the regulation of granuloma formation. However, using vitamin D metabolites to assess the activity of the disease is still problematic, and its usefulness is disputable. In some cases, though, a calcium metabolism disorder could be a valuable tool (i.e. as a marker of extrathoracic sarcoidosis). Although sarcoidosis does not cause a decrease in bone mineral density, increased incidence of vertebral deformities is noted. Despite increasing knowledge about calcium homeostasis disorders in patients with sarcoidosis, there is still a need for clear guidelines regarding calcium and vitamin D supplementation in these patients.

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Factors Associated with Bone Mineral Density and Bone Resorption Markers in Postmenopausal HIV-Infected Women on Antiretroviral Therapy: A Prospective Cohort Study

Nutrients ◽

10.3390/nu13062090 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2090

Author(s):

Christa Ellis ◽

Herculina S Kruger ◽

Michelle Viljoen ◽

Joel A Dave ◽

Marlena C Kruger

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Antiretroviral Therapy ◽

Bone Resorption ◽

Bone Mineral ◽

Effect Size ◽

Mineral Density ◽

Bone Resorption Markers ◽

Factors Associated ◽

Over Time

The study aimed to determine factors associated with changes in bone mineral density (BMD) and bone resorption markers over two years in black postmenopausal women living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART). Women (n = 120) aged > 45 years were recruited from Potchefstroom, South Africa. Total lumbar spine and left femoral neck (LFN) BMD were measured with dual energy X-ray absorptiometry. Fasting serum C-Telopeptide of Type I collagen (CTx), vitamin D and parathyroid hormone were measured. Vitamin D insufficiency levels increased from 23% at baseline to 39% at follow up. In mixed linear models serum CTx showed no change from baseline to end (p = 0.363, effect size = 0.09). Total and LFN BMD increased significantly over two years, but effect sizes were small. No significant change in spine BMD over time was detected (p = 0.19, effect size = 0.02). Age was significantly positively associated with CTx over time, and negatively with total and LFN BMD. Physical activity (PA) was positively associated with LFN BMD (p = 0.008). Despite a decrease in serum vitamin D, BMD and CTx showed small or no changes over 2 years. Future studies should investigate PA interventions to maintain BMD in women living with HIV.

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