Denise L Jacobson1, Charles B Stephensen, Tracie L Miller, Kunjal Patel, Janet S Chen, Russell B Van Dyke, Ayesha Mirza, Gertrud U Schuster, Rohan Hazra, Angela Ellis, Sean S Brummel, Mitchell E Geffner, Margarita Silio, Stephen A Spector, Linda A DiMeglio. 1. *Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA;†USDA Western Human Nutrition Research Center, University of California, Davis, CA;‡Division of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine at the University of Miami, Miami, FL;§Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;‖Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA;¶Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA;#Department of Pediatrics, University of Florida, Jacksonville, FL;**Nutrition Department, University of California, Davis, CA;††Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD;‡‡Frontier Science & Technology Research Foundation, Amherst, NY;§§The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA;‖‖Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CA; and¶¶Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
Abstract
BACKGROUND: Perinatally HIV-infected (PHIV) children have, on average, lower bone mineral density (BMD) than perinatally HIV-exposed uninfected (PHEU) and healthy children. Low 25-hydroxy vitamin D [25(OH)D] and elevated parathyroid hormone (PTH) concentrations may lead to suboptimal bone accrual. METHODS: PHIV and PHEU children in the Pediatric HIV/AIDS Cohort Study had total body (TB) and lumbar spine (LS) BMD and bone mineral content (BMC) measured by dual-energy x-ray absorptiometry; BMD z-scores (BMDz) were calculated for age and sex. Low 25(OH)D was defined as ≤20 ng/mL and high PTH as >65 pg/mL. We fit linear regression models to estimate the average adjusted differences in BMD/BMC by 25(OH)D and PTH status and log binomial models to determine adjusted prevalence ratios of low 25(OH)D and high PTH in PHIV relative to PHEU children. RESULTS: PHIV children (n = 412) were older (13.0 vs. 10.8 years) and more often black (76% vs. 64%) than PHEU (n = 207). Among PHIV, children with low 25(OH)D had lower TB-BMDz [SD, -0.38; 95% confidence interval (CI), -0.60 to -0.16] and TB-BMC (SD, -59.1 g; 95% CI, -108.3 to -9.8); high PTH accompanied by low 25(OH)D was associated with lower TB-BMDz. Among PHEU, children with low 25(OH)D had lower TB-BMDz (SD, -0.34; 95% CI, -0.64 to -0.03). Prevalence of low 25(OH)D was similar by HIV status (adjusted prevalence ratio, 1.00; 95% CI, 0.81 to 1.24). High PTH was 3.17 (95% CI, 1.25 to 8.06) times more likely in PHIV children. CONCLUSIONS: PHIV and PHEU children with low 25(OH)D may have lower BMD. Vitamin D supplementation trials during critical periods of bone accrual are needed.
BACKGROUND: Perinatally HIV-infected (PHIV) children have, on average, lower bone mineral density (BMD) than perinatally HIV-exposed uninfected (PHEU) and healthy children. Low 25-hydroxy vitamin D [25(OH)D] and elevated parathyroid hormone (PTH) concentrations may lead to suboptimal bone accrual. METHODS: PHIV and PHEU children in the Pediatric HIV/AIDS Cohort Study had total body (TB) and lumbar spine (LS) BMD and bone mineral content (BMC) measured by dual-energy x-ray absorptiometry; BMD z-scores (BMDz) were calculated for age and sex. Low 25(OH)D was defined as ≤20 ng/mL and high PTH as >65 pg/mL. We fit linear regression models to estimate the average adjusted differences in BMD/BMC by 25(OH)D and PTH status and log binomial models to determine adjusted prevalence ratios of low 25(OH)D and high PTH in PHIV relative to PHEU children. RESULTS: PHIV children (n = 412) were older (13.0 vs. 10.8 years) and more often black (76% vs. 64%) than PHEU (n = 207). Among PHIV, children with low 25(OH)D had lower TB-BMDz [SD, -0.38; 95% confidence interval (CI), -0.60 to -0.16] and TB-BMC (SD, -59.1 g; 95% CI, -108.3 to -9.8); high PTH accompanied by low 25(OH)D was associated with lower TB-BMDz. Among PHEU, children with low 25(OH)D had lower TB-BMDz (SD, -0.34; 95% CI, -0.64 to -0.03). Prevalence of low 25(OH)D was similar by HIV status (adjusted prevalence ratio, 1.00; 95% CI, 0.81 to 1.24). High PTH was 3.17 (95% CI, 1.25 to 8.06) times more likely in PHIV children. CONCLUSIONS: PHIV and PHEU children with low 25(OH)D may have lower BMD. Vitamin D supplementation trials during critical periods of bone accrual are needed.
Authors: Denise L Jacobson; Kunjal Patel; George K Siberry; Russell B Van Dyke; Linda A DiMeglio; Mitchell E Geffner; Janet S Chen; Elizabeth J McFarland; William Borkowsky; Margarita Silio; Roger A Fielding; Suzanne Siminski; Tracie L Miller Journal: Am J Clin Nutr Date: 2011-11-02 Impact factor: 7.045
Authors: Kumaravel Rajakumar; Charity G Moore; Jonathan Yabes; Flora Olabopo; Mary Ann Haralam; Diane Comer; Jaimee Bogusz; Anita Nucci; Susan Sereika; Jacqueline Dunbar-Jacob; Michael F Holick; Susan L Greenspan Journal: J Clin Endocrinol Metab Date: 2015-06-19 Impact factor: 5.958
Authors: Craig F Munns; Nick Shaw; Mairead Kiely; Bonny L Specker; Tom D Thacher; Keiichi Ozono; Toshimi Michigami; Dov Tiosano; M Zulf Mughal; Outi Mäkitie; Lorna Ramos-Abad; Leanne Ward; Linda A DiMeglio; Navoda Atapattu; Hamilton Cassinelli; Christian Braegger; John M Pettifor; Anju Seth; Hafsatu Wasagu Idris; Vijayalakshmi Bhatia; Junfen Fu; Gail Goldberg; Lars Sävendahl; Rajesh Khadgawat; Pawel Pludowski; Jane Maddock; Elina Hyppönen; Abiola Oduwole; Emma Frew; Magda Aguiar; Ted Tulchinsky; Gary Butler; Wolfgang Högler Journal: J Clin Endocrinol Metab Date: 2016-01-08 Impact factor: 5.958
Authors: Sean S Brummel; Kumud K Singh; Adam X Maihofer; Mona Farhad; Min Qin; Terry Fenton; Caroline M Nievergelt; Stephen A Spector Journal: J Acquir Immune Defic Syndr Date: 2016-04-15 Impact factor: 3.731
Authors: Denise L Jacobson; Jane C Lindsey; Catherine M Gordon; Jack Moye; Dana S Hardin; Kathleen Mulligan; Grace M Aldrovandi Journal: AIDS Date: 2010-03-13 Impact factor: 4.177
Authors: Denise L Jacobson; Jane C Lindsey; Catherine Gordon; Rohan Hazra; Hans Spiegel; Flavia Ferreira; Fabiana R Amaral; Jesica Pagano-Therrien; Aditya Gaur; Kathy George; Jane Benson; George K Siberry Journal: Clin Infect Dis Date: 2020-08-22 Impact factor: 9.079
Authors: Denise L Jacobson; Wendy Yu; Rohan Hazra; Sean Brummel; Mitchell E Geffner; Kunjal Patel; William Borkowsky; Jiajia Wang; Janet S Chen; Ayesha Mirza; Linda A DiMeglio Journal: Bone Date: 2020-06-30 Impact factor: 4.398
Authors: Renee Margossian; Paige L Williams; Wendy Yu; Denise L Jacobson; Mitchell E Geffner; Linda A DiMeglio; Russell B Van Dyke; Stephen A Spector; Gertrud U Schuster; Charles B Stephensen; Tracie L Miller; Steven E Lipshultz Journal: J Acquir Immune Defic Syndr Date: 2019-06-01 Impact factor: 3.731
Authors: Justin Penner; Rashida A Ferrand; Ceri Richards; Kate A Ward; James E Burns; Celia L Gregson Journal: PLoS One Date: 2018-11-15 Impact factor: 3.240