The association between 25-hydroxyvitamin D and parathyroid hormone in adolescents living with HIV in southern Africa: A cross sectional study

Madanhire, Tafadzwa, Ward, Kate A., MacDougall, Amy, Mohammed, Nuredin I., Kasonka, Lackson, Mabuda, Hildah B., Chisenga, Molly, Tang, Jonathan C. Y., Fraser, William D., Bandason, Tsitsi, Dzavakwa, Nyasha V., Simms, Victoria, Ferrand, Rashida A. and Gregson, Celia L. (2025) The association between 25-hydroxyvitamin D and parathyroid hormone in adolescents living with HIV in southern Africa: A cross sectional study. British Journal of Nutrition. ISSN 0007-1145

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Abstract

Low vitamin D associated with high parathyroid hormone (PTH) is commonly reported in the context of HIV infection. We determined the association between total 25-hydroxyvitamin-D [25(OH)D] and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11-19 years) perinatally-infected with HIV and established on antiretroviral therapy (ART) for ≥6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured, and fasted serum concentrations of 1,25-dihydroxyvitamin-D (1,25(OH)2D), total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression modelling. 842 participants (female: 53.2%) with median age 15.5 (IQR:13.2-17.9) years were enrolled. Median ART duration was 9.8 [IQR:6.3-12.3] years and 165/841 (19.6%) had an HIV viral load >60copies/ml. Stunting (HAZ score<-2) and underweight (WAZ score<-2) were observed in 29.9% and 30.0% respectively. Three quarters (n=639) reported daily calcium intakes <150mg/day. The mean (SD) concentrations of total 25(OH)D and 1,25(OH)2D were 66.1(16.5) nmol/L and 210.6(70.4) pmol/L respectively, and median PTH level was 4.3 (IQR:3.3-5.5) pmol/L. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling-off at 74.6nmol/L (95%CI: 74.5-75.2). Results were consistent in those taking tenofovir disoproxil fumarate (81.7%) and in those who were virally unsuppressed. In this population with extremely low habitual calcium intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75nmol/L, potentially suggests levels of 25(OH)D >75nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

Item Type:	Article
Uncontrolled Keywords:	sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Depositing User:	LivePure Connector
Date Deposited:	24 Mar 2025 15:30
Last Modified:	31 Mar 2025 09:32
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98877
DOI:	10.1017/S0007114525000509

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