Association of Vitamin D with Risk Factors for Coronary Artery Disease

Introduction:Vitamin D safeguards cardiovascular health by reducing inflammation and susceptibility to atheroma. This study aimed to evaluate the association of coronary artery disease (CAD) and its risk factors like body mass index (BMI), glycated hemoglobin (HbA1c), and lipid profile with vitamin D. Methods:Patients of both genders aged over 18 years, who underwent coronary angiogram for cardiac symptoms such as chest pain, breathlessness, palpitation, or syncope, were enrolled in the present study. Demographic and anthropometric data were collected. Glycated hemoglobin, lipid profile and 25-hydroxyvitamin D were measured. The severity of CAD was analyzed along with the SYNTAX scoring. Results:The study population was divided into three groups based on vitamin D levels: Group I (vitamin D level <20 ng/mL), Group II (20-30 ng/mL) and Group III (>30 ng/mL). There was a significantly higher number of patients with diabetes mellitus and triple vessel disease in Group I. On multivariable suplogistic regression, vitamin D had a significant odds ratio (OR) of 1.21 (1.03-1.43) for single vessel disease and 0.92 (1.13-1.43) for triple vessel disease. SYNTAX score had a significant OR of 0.697 (0.557-0.873) for single vessel disease and 1.27 (1.13-1.43) for triple vessel disease. There was a significant negative correlation between HbA1c and vitamin D (r =-0.269, p= 0.008). Vitamin D levels negatively correlated with triple vessel disease (r =-0.252, p= 0.013). Conclusions:Incidence of diabetes mellitus and levels of HbA1c were both higher among patients with vitamin D deficiency. Vitamin D deficiency was a risk factor for single and triple vessel disease.

Risk Factors Of Anaemia Among Zidovudine-Based Regimen In Patients With Hiv Infection- A Cohort Study

BACKGROUND

Anaemia in patients with HIV infection is commonly multifactorial in origin. Nutritional deficiencies and the presence of opportunistic infections as well as HIV infection itself can cause anaemia. HIV medications like zidovudine can also cause anaemia in patients with HIV infection. This study aimed to study the prevalence and risk factors of anaemia in patients with HIV infection on a zidovudine-based HAART regimen.

METHODS

This hospital-based prospective cohort study was done at the ART (anti-retroviral therapy) centre. All adult patients with HIV attending the ART centre were included in the study. After obtaining written informed consent, the patient's demographic data, risk factors, WHO staging, and body mass index (BMI) were noted. Study population was divided into two groups as patients with or without anaemia and compared using appropriate statistical tests.

RESULTS

Out of the 202 patients with HIV infection on a zidovudine-based regimen, 52 patients (25.7%) developed anaemia. Anaemia was common in stage 3 or stage 4 of WHO staging (OR-9.94, CI-3.89-25.36) and in patients with low CD4 counts (OR-0.988, CI-0. 982-0.995). Patients with anaemia had significant opportunistic infections.

CONCLUSIONS

Anaemia is common in patients with HIV on zidovudine-based HAART regimen, which is seen as early as less than 8 weeks. WHO staging, and CD4 count were the primary risk factors for anaemia, which a change of treatment regimen and supportive measures can reverse.