Vitamin D Status and the Relationship with Bone Fragility Fractures in HIV-Infected Patients: A Case Control Study
Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Infectious Diseases Unit-ARNAS Civico, Di Cristina, Benfratelli, 90127 Palermo, Italy
Department of Health Promotion Sciences and Mother and Child Care “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2018, 19(1), 119; https://doi.org/10.3390/ijms19010119
Received: 5 December 2017 / Revised: 20 December 2017 / Accepted: 23 December 2017 / Published: 2 January 2018
(This article belongs to the Special Issue Vitamin D and Human Health)
HIV-infected patients show high risk of fracture. The aims of our study were to determine the prevalence of vertebral fractures (VFs) and their associations with vitamin D in HIV patients. 100 patients with HIV infection and 100 healthy age- and sex-matched controls were studied. Bone mineral density was measured by quantitative ultrasound at the non-dominant heel. Serum osteocalcin and C-terminal telopeptide of collagen type 1 served as bone turnover markers. Bone ultrasound measurements were significantly lower in patients compared with controls (Stiffness Index (SI): 80.58 ± 19.95% vs. 93.80 ± 7.10%, respectively, p < 0.001). VFs were found in 16 patients and in 2 controls. HIV patients with vertebral fractures showed lower stiffness index (SI) (70.75 ± 10.63 vs. 83.36 ± 16.19, respectively, p = 0.045) and lower vitamin D levels (16.20 ± 5.62 vs. 28.14 ± 11.94, respectively, p < 0.02). The majority of VFs (87.5%) were observed in HIV-infected patients with vitamin D insufficiency, and regression analysis showed that vitamin D insufficiency was significantly associated with vertebral fractures (OR 9.15; 95% CI 0.18–0.52, p < 0.04). VFs and are a frequent occurrence in HIV-infected patients and may be associated with vitamin D insufficiency.