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Abreu JM, Nogueira ABB, Villela MM, Módolo DM, Panaro TC, Setubal S, Velarde LGC, Lima GAB, da Cruz Filho RA, Soares DV. Low bone mass and vitamin D in Brazilian people living with HIV under antiretroviral therapy. Arch Osteoporos 2022; 17:40. [PMID: 35247128 DOI: 10.1007/s11657-022-01088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/26/2022] [Indexed: 02/03/2023]
Abstract
We performed a cross-sectional study in 212 PLHIV under antiretroviral therapy. Bone mass was compromised in 36.5% of relatively young sample and associated with hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was present in 85%, especially those on NNRTI. PURPOSE Previous studies have reported an increased prevalence of bone demineralization among people living with the human immunodeficiency virus (PLHIV). We aimed to assess bone mineral density (BMD), vitamin D levels, and associated risk factors in Brazilian PLHIV. METHODS Cross-sectional study with 212 patients in a specialized assistance service. Clinical and demographic information were registered. Laboratory tests were performed, and BMD was measured at the lumbar spine, total hip/femoral neck, and forearm by dual-energy X-ray absorptiometry. Participants were classified into "with low bone mass (wLBM)" and "without low bone mass (woLBM)." Those wLBM encompasses osteoporosis, osteopenia, and below the expected range for age as recommended by the World Health Organization. RESULTS One hundred and eighty-seven patients were included. Median age was 46.3 years (interquartile range (IQR) 40-52) and duration of HAART exposure was 11.2 years (IQR 7-15). Plasma viral load was undetectable in 79%. Hypovitaminosis D (< 30 ng/mL) was present in 85% and LBM in 36.5%. Men wLBM were more likely to have testosterone deficiency and had higher PTH levels than those woLBM. LBM in women was associated with older age, menopause, and metabolic syndrome. CONCLUSION This study showed a high frequency of LBM in a relatively young sample, and suggests a detrimental effect of hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was frequent, especially those on non-nucleoside reverse transcriptase inhibitor, higher body mass index, and abdominal circumference.
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Affiliation(s)
- Juliana Mendes Abreu
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil.
| | - Amanda B B Nogueira
- Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Mariana M Villela
- Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Denise M Módolo
- Scientific Initiation Program of the Medical Graduation Course, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Thaís C Panaro
- Scientific Initiation Program of the Medical Graduation Course, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Sérgio Setubal
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | | | - Giovanna A B Lima
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | - Rubens A da Cruz Filho
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | - Debora V Soares
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
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Dong R, Lin H, Chen X, Shi R, Yuan S, Li J, Zhu B, Xu X, Shen W, Wang K, Shu XO, Ding D, He N. Gut Microbiota and Fecal Metabolites Associated With Neurocognitive Impairment in HIV-Infected Population. Front Cell Infect Microbiol 2021; 11:723840. [PMID: 34760715 PMCID: PMC8574817 DOI: 10.3389/fcimb.2021.723840] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/04/2021] [Indexed: 01/18/2023] Open
Abstract
Gut microbiota dysbiosis has been associated with many neurological diseases. However, how microbiota composition and metabolism relate to neurocognitive impairment (NCI) in HIV-infected individuals is largely unknown. In this study, a total of 102 HIV infected participants were classified into two groups—those with NCI and those without—using the global deficit score (GDS). Fecal samples were collected from the participants for 16S rRNA gene sequencing and untargeted metabolomics. The plasma level of 25 hydroxy-vitamin D (25(OH)D) was also evaluated. Although α-diversity and β-diversity were comparable, the HIV patients with NCI were significantly different from those without NCI in terms of abundance of several gut microbiota. The decreased abundance of butyrate-producing bacteria (BPB) and increased abundance of Klebsiella were related with NCI and carotid intima-media thickness (CIMT). Significant differences in fecal metabolites were also found between individuals with versus without NCI, including increased bile acids and bioactive lipids, decreased vitamin D, terpenoids, and resolvin D1 in the NCI group. Furthermore, the perturbed metabolic profile was closely related to BPB and Klebsiella. In addition, a low level of vitamin D was associated with NCI and CIMT. Both fecal and plasma vitamin D were positively correlated with BPB. Our results show that BPB and Klebsiella and the associated metabolites are associated with NCI in people with HIV. In addition, vitamin D, both in feces and blood, was associated with NCI and BPB, suggesting a protective effect of vitamin D on NCI.
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Affiliation(s)
- Ruihua Dong
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China.,Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Haijiang Lin
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Department of Epidemiology, Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Xiaoxiao Chen
- Department of Epidemiology, Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Ruizi Shi
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Shiying Yuan
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jing Li
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Bowen Zhu
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaohui Xu
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Weiwei Shen
- Department of Epidemiology, Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Keran Wang
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Na He
- Department of Epidemiology, School of Public Health and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Shanghai Institute of Infectious Diseases and Biosecurity, Fudan University, Shanghai, China
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Gregório PC, Bucharles S, da Cunha RS, Braga T, Almeida AC, Henneberg R, Stinghen AE, Barreto FC. In vitro anti-inflammatory effects of vitamin D supplementation may be blurred in hemodialysis patients. Clinics (Sao Paulo) 2021; 76:e1821. [PMID: 33624705 PMCID: PMC7885853 DOI: 10.6061/clinics/2021/e1821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the potential anti-inflammatory effects of vitamin D supplementation under uremic conditions, both in vivo and in vitro, and its effects on the parameters of mineral metabolism. METHODS Thirty-two hemodialysis patients were randomly assigned to receive placebo (N=14) or cholecalciferol (N=18) for six months. Serum levels of calcium, phosphate, total alkaline phosphatase, intact parathyroid hormone (iPTH), and vitamin D were measured at baseline and after three and six months. The levels of fibroblast growth factor-23 (FGF-23), interleukin-1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP) were also measured at baseline and at six months. Human monocytes were used for in vitro experiments and treated with cholecalciferol (150 nM) and uremic serum. Cell viability, reactive oxygen species (ROS) production, and cathelicidin (CAMP) expression were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, dichloro-dihydro-fluorescein diacetate assay, and real time-quantitative polymerase chain reaction, respectively. RESULTS Both patient groups were clinically and biochemically similar at baseline. After six months, the levels of vitamin D and iPTH were higher and lower, respectively, in the cholecalciferol group than in the placebo group (p<0.05). There was no significant difference between the parameters of mineral metabolism, such as IL-1β and hs-CRP levels, in both groups. Treatment with uremic serum lowered the monocyte viability (p<0.0001) and increased ROS production (p<0.01) and CAMP expression (p<0.05); these effects were counterbalanced by cholecalciferol treatment (p<0.05). CONCLUSIONS Thus, cholecalciferol supplementation is an efficient strategy to ameliorate hypovitaminosis D in hemodialysis patients, but its beneficial effects on the control of secondary hyperparathyroidism are relatively unclear. Even though cholecalciferol exhibited anti-inflammatory effects in vitro, its short-term supplementation was not effective in improving the inflammatory profile of patients on hemodialysis, as indicated by the IL-1β and hs-CRP levels.
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Affiliation(s)
- Paulo C. Gregório
- Laboratorio de Nefrologia Experimental, Departamento de Patologia Basica, Universidade Federal do Parana, Curitiba, PR, BR
| | - Sergio Bucharles
- Departamento de Medicina Interna, Divisao de Nefrologia, Universidade Federal do Parana, Curitiba, PR, BR
| | - Regiane S. da Cunha
- Laboratorio de Nefrologia Experimental, Departamento de Patologia Basica, Universidade Federal do Parana, Curitiba, PR, BR
| | - Tárcio Braga
- Laboratorio de Nefrologia Experimental, Departamento de Patologia Basica, Universidade Federal do Parana, Curitiba, PR, BR
| | - Ana Clara Almeida
- Programa de Pos-Graduacao em Ciencias da Saude, Pontificia Universidade Catolica do Parana, Curitiba, PR, BR
| | - Railson Henneberg
- Departamento de Analises Clinicas, Universidade Federal do Parana, Curitiba, PR, BR
| | - Andréa E.M. Stinghen
- Laboratorio de Nefrologia Experimental, Departamento de Patologia Basica, Universidade Federal do Parana, Curitiba, PR, BR
| | - Fellype C. Barreto
- Departamento de Medicina Interna, Divisao de Nefrologia, Universidade Federal do Parana, Curitiba, PR, BR
- *Corresponding author. E-mail:
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Abstract
PURPOSE OF REVIEW Vitamin D (VitD) deficiency is highly prevalent among HIV-infected individuals. Given the overlapping risk for several chronic disease and immunomodulatory outcomes from both long-standing HIV and VitD deficiency, there is great interest in clarifying the clinical role of VitD for this population. RECENT FINDINGS Recent studies have expanded our knowledge regarding the epidemiology and mechanisms of VitD deficiency-associated outcomes in the setting of HIV. Clinical trials focusing on VitD supplementation have demonstrated a positive impact on bone mineral density in subgroups of HIV-infected individuals initiating ART or on suppressive ART regimens; however, significant heterogeneity exists between studies and data are less consistent with other clinical outcomes. Further research is needed to clarify uncertainly in several domains, including identifying patients at greatest risk for poor outcomes from VitD deficiency, standardizing definitions and measurement techniques, and better quantifying the benefits and risks of VitD supplementation across different demographic strata for skeletal and extra-skeletal outcomes.
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Affiliation(s)
- Evelyn Hsieh
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, TAC S-525, PO Box 208031, New Haven, CT, 06517, USA.
| | - Michael T Yin
- Division of Infectious Diseases, Columbia University Medical Center, New York, NY, USA
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Zofkova I, Nemcikova P. Osteoporosis complicating some inborn or acquired diseases. Physiol Res 2018; 67:S441-S454. [PMID: 30484671 DOI: 10.33549/physiolres.934027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Osteoporosis in chronic diseases is very frequent and pathogenetically varied. It complicates the course of the underlying disease by the occurrence of fractures, which aggravate the quality of life and increase the mortality of patients from the underlying disease. The secondary deterioration of bone quality in chronic diseases, such as diabetes of type 1 and type 2 and/or other endocrine and metabolic disorders, as well as inflammatory diseases, including rheumatoid arthritis - are mostly associated with structural changes to collagen, altered bone turnover, increased cortical porosity and damage to the trabecular and cortical microarchitecture. Mechanisms of development of osteoporosis in some inborn or acquired disorders are discussed.
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Affiliation(s)
- I Zofkova
- Institute of Endocrinology, Prague, Czech Republic, Department of Nuclear Medicine, České Budějovice Hospital, Czech Republic.
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Zhao S, Cao S, Luo L, Zhang Z, Yuan G, Zhang Y, Yang Y, Guo W, Wang L, Chen F, Wu Q, Li L. A preliminary investigation of metal element profiles in the serum of patients with bloodstream infections using inductively-coupled plasma mass spectrometry (ICP-MS). Clin Chim Acta 2018; 485:323-332. [PMID: 30017616 DOI: 10.1016/j.cca.2018.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/30/2018] [Accepted: 07/09/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND We determined metal element profiles (MEPs) by inductively-coupled plasma mass spectrometry (ICP-MS) in the serum of patients with blood stream infection (BSI) and find out very important (VIP) metal elements in specific infections. METHODS Sixty-eight metal elements were identified in both serum and the bacteria isolated from 14 BSI patients with Staphylococcus infection, 39 with Enterobacteriaceae infection, 5 with Enterococcus infection and 58 healthy subjects without infection by ICP-MS methods. Statistical analysis, Principal Component Analysis (PCA) and Partial Least Squares Discriminant Analysis (PLS-DA) were performed to process data among different groups, select differential metal elements and operate correlation analysis. RESULTS The MEPs in the serum of BSI patients with 4 types of bacteria (Staphylococcus aureus, Escherichia coli, Enterococcus faecium, and Klebsiella pneumonia), and the corresponding MEPs of the bacteria were established. VIP metal elements were screened out in different BSI patients. Correlation analysis showed that there were some correlations between serum concentrations of metal elements and bacterial infection. CONCLUSION We found differential metal elements in the serum of BSI patients compared with controls, thus providing a basis for the diagnosis, prevention and treatment of BSI from the perspective of metallomics.
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Affiliation(s)
- Suying Zhao
- Department of laboratory medicine, The Affiliated hospital of Nanjing university of Traditional ChineseMedicine, Nanjing 210009, China
| | - Shuyuan Cao
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Lan Luo
- Nanjing entry-exit inspection and quarantine bureau, Nanjing 211106,China
| | - Zhan Zhang
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Gehui Yuan
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yanan Zhang
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yanting Yang
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Weihui Guo
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Li Wang
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Feng Chen
- Department of Epidemiology and Biostatistics and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Qian Wu
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Lei Li
- Department of Hygienic Analysis and Detection and Ministry of Education Key Lab for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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