Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents

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

Research output: Contribution to journalArticle

Abstract

Background:Disordered bone mineral metabolism and low vitamin D concentrations are associated with cardiovascular abnormalities; few studies have evaluated this relationship in HIV-infected youth.Setting:The Adolescent Master Protocol is a Pediatric HIV/AIDS Cohort Study network study conducted across 14 US sites.Methods:Among 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.Results:Among 485 participants (305 PHIV and 180 PHEU) with echocardiograms and bone mineralization measures, low 25-OHD (<20 ng/mL) was common among all participants (48% PHIV and 44% PHEU), but elevated PTH (>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.Conclusions:In 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.

Original languageEnglish (US)
Pages (from-to)238-246
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume81
Issue number2
DOIs
StatePublished - Jun 1 2019

Keywords

  • 25-hydroxy-vitamin D
  • HIV infection
  • cardiac function
  • children
  • parathyroid hormone

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Margossian, R., Williams, P. L., Yu, W., Jacobson, D. L., Geffner, M. E., Dimeglio, L. A., Van Dyke, R. B., Spector, S. A., Schuster, G. U., Stephensen, C. B., Miller, T. L., & Lipshultz, S. E. (2019). Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents. Journal of Acquired Immune Deficiency Syndromes, 81(2), 238-246. https://doi.org/10.1097/QAI.0000000000002007