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
Additional Information:	Data availability statement: The datasets used and/or analysed during the present study are available from the corresponding author upon reasonable request through the London School of Hygiene and Tropical Medicine DataCompass. Funding information: The trial is funded by the European & Developing Countries Clinical Trials Partnership (RIA2018CO-2512). The research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number D43TW011326 and Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD) to TM. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. RAF is funded by the Wellcome Trust (grant no. 206316_Z_17_Z).
Uncontrolled Keywords:	africa,hiv,vitamin d,adolescent,parathyroid hormone,nutrition and dietetics,medicine (miscellaneous),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2900/2916
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
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	24 Mar 2025 15:30
Last Modified:	25 Apr 2025 00:35
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98877
DOI:	10.1017/S0007114525000509

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