1. Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents.
- Author
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Margossian, Renee, Williams, Paige L, Yu, Wendy, Jacobson, Denise L, Geffner, Mitchell E, DiMeglio, Linda A, Van Dyke, Russell B, Spector, Stephen A, Schuster, Gertrud U, Stephensen, Charles B, Miller, Tracie L, and Lipshultz, Steven E
- Subjects
Clinical Research ,Cardiovascular ,Pediatric AIDS ,Pediatric ,HIV/AIDS ,Heart Disease ,Prevention ,Musculoskeletal ,Good Health and Well Being ,Adolescent ,Biomarkers ,Bone Density ,Bone and Bones ,Calcium ,Cardiovascular Abnormalities ,Child ,Cohort Studies ,Echocardiography ,Female ,Fibroblast Growth Factor-23 ,Fibroblast Growth Factors ,HIV Infections ,Humans ,Infectious Disease Transmission ,Vertical ,Male ,Minerals ,Parathyroid Hormone ,Phosphates ,United States ,Vitamin D ,25-hydroxy-vitamin D ,parathyroid hormone ,cardiac function ,HIV infection ,children ,Pediatric HIV/AIDS Cohort Study ,Clinical Sciences ,Public Health and Health Services ,Virology - Abstract
BackgroundDisordered bone mineral metabolism and low vitamin D concentrations are associated with cardiovascular abnormalities; few studies have evaluated this relationship in HIV-infected youth.SettingThe Adolescent Master Protocol is a Pediatric HIV/AIDS Cohort Study network study conducted across 14 US sites.MethodsAmong perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected (PHEU) youth enrolled in the Adolescent Master Protocol, we evaluated associations of vitamin D [measured as 25-hydroxy-vitamin D (25-OHD)], parathyroid hormone (PTH), calcium, phosphate, and fibroblast growth factor-23 (FGF-23) concentrations with echocardiographic measures of left ventricular (LV) structure, function, and concentrations of NT-proBNP, a biomarker of cardiac damage.ResultsAmong 485 participants (305 PHIV and 180 PHEU) with echocardiograms and bone mineralization measures, low 25-OHD (65 pg/mL) was identified more often among PHIV participants than PHEU participants (9% vs 3%, P = 0.02). After adjusting for HIV status and demographic covariates, both low 25-OHD and elevated PTH were associated with lower mean LV mass z-scores, whereas elevated PTH was associated with higher mean fractional shortening z-scores. Participants with low 25-OHD also had slightly higher mean LV end-systolic wall stress z-scores, but differences were more pronounced in PHEU participants than in PHIV participants. FGF-23 was inversely related to end-diastolic septal thickness, both overall and among PHIV participants.ConclusionsIn this cohort of PHIV and PHEU youth, we observed associations of 25-OHD, PTH, and FGF-23 with both structural and functional cardiac parameters, supporting links between bone mineral metabolism and cardiac status.
- Published
- 2019