Vitamin D Deficiency, Inflammation and Age-related disease in HIV-Infected Men

描述：人们对维生素D补充剂是否有可能影响老年HIV感染人群的健康产生了极大的兴趣。据估计，60%的艾滋病毒感染者患有亚临床维生素D缺乏症。鉴于维生素D已确立的免疫调节作用及其众多其他功能，有坚实的基础假设维生素D缺乏可能对老年艾滋病毒感染者产生疾病风险后果。这项建议的基本动机是使用更全面的方法来了解维生素D代谢物水平和炎症之间的复杂关系，以及它们与艾滋病毒感染者的衰老结果之间的关系。这项拟议的研究将在HAART启动的关键时间点之前和之后测量两种维生素D代谢物(25[OH]D和活性形式1，25[OH]2D)。通过这些措施，我们将利用500名艾滋病毒感染者的现有炎症生物标记物数据平台，研究炎症、维生素D代谢和年龄相关疾病之间的复杂联系。这项研究包括来自美国四个研究地点的参与者以及来自华盛顿大学和约翰·霍普金斯大学的合作者。这项研究的具体目的是：1)表征不同年龄和HIV状态的血清25[OH]和1，25[OH]2D水平，并评估HAART启动前后血清25[OH]和1，25[OH]2D水平与可用炎症标志物的相关性2)确定HAART前后血清25[OH]和1，25[OH]2D水平之间的关系，以及年龄和HIV状态对免疫重建和慢性病/老年预后的影响。了解艾滋病毒感染者体内维生素D代谢的变化，以及对老龄化人口的疾病风险和功能不良的影响，是一个重要的问题，将得到拟议的流行病学研究的支持。正在评估的生物标记物可以根据它们在体内的水平进行修改，因此有可能形成降低疾病风险的干预措施的基础。

DESCRIPTION: There has been great interest in whether vitamin D supplementation might hold potential for influencing health in aging HIV-infected populations. An estimated 60% of HIV-infected persons have subclinical vitamin D deficiency. Given the established immunomodulatory role of vitamin D as well as its myriad other functions, there is a firm foundation for hypothesizing vitamin D deficiency might have disease risk consequences for older HIV-infected persons. The underlying motivation for this proposal is to use a more comprehensive approach to understanding the complex relationships between vitamin D metabolite levels and inflammation and how they relate to aging outcomes among HIV-infected persons. The proposed study will measure two vitamin D metabolites (25[OH]D and the active form, 1,25[OH]2D), before and after the critical time point of HAART initiation. With these measures, we will capitalize on an existing platform of inflammatory biomarker data in 500 HIV- infected men to study the complex connections between inflammation, vitamin D metabolism and age-related disease. The study includes participants from four study sites across the United States and collaborators from University of Washington and Johns Hopkins University. The specific aims of this study are: 1) Characterize serum 25[OH] and 1,25[OH]2D levels across strata of age and HIV-status and evaluate the association of each metabolite with available inflammatory markers before and after HAART initiation 2) Determine the association between serum 25[OH] and 1,25[OH]2D levels pre- and post- HAART and both immune reconstitution and chronic disease/geriatric outcomes by age and HIV-status. Understanding how vitamin D metabolism may vary in HIV-infected individuals and impact risk of disease and poor functioning in an aging population is an important issue that will be supported by the proposed epidemiologic research. The biomarkers being evaluated are modifable in terms of their levels in the body and thus have the potential to form the basis of an intervention for lowering risk of disease.