Association of Vitamin D Serum Levels and Periodontal Disease Severity in HIV Seropositive Women

Vitamin D (VitD) deficiency is commonly observed in women and among people living with human immunodeficiency virus (HIV). Abnormally low serum VitD levels are often associated with negative health outcomes. Association between VitD status and periodontitis in HIV has yet to be explored. In this study we examine the association of VitD serum levels with the severity of periodontal disease in HIV + women. We hypothesized a positive association between VitD deficiency and poor periodontal health. Materials and Methods: Serum 25(OH) VitD and mean (m) Periodontal Disease markers (number of teeth (NoT), Clinical Attachment Loss (CAL), Probing Depth (PD), Bleeding Index (BI), Plaque Index (PI) and Periodontal Disease Diagnosis (CDC/AAP definition) were investigated cross-sectionally in 75 HIV+ Chicago Women's Interagency HIV oral substudy participants between 1995 and 2003. VitD deficiency was defined as <20ng/ml. Linear regression was used to determine associations between PDmarkers and VitD deficiency for the total sample (including smoking status) and with stratification by current tobacco smoking status. All available potential covariates (age, race, education, smoking, mPI, VL, CD4 and use of HAART) were entered into each Linear Regression model. Only the variables that were significant on the 0.10 level were retained in the final multivariate model. Association between PDmarkers and VitD Deficiency, after confounder adjustment, was considered statistically significant when P value was <0.05. Results: Participants were predominantly African Americans (71%) and smokers (52%); mean age was 39.5 y/o; 43% had completed high school. Mean Biomarkers levels were VitD (20.2ng/ml), HIV Viral Load (VL) (123x103 copies/ml), CD4 count (351/mm3). 12% reported using highly active antiretroviral therapy (HAART). Average NoT was 20.7, mPD (1.7mm), mCAL (1.2mm), mBI (0.2) mPI (0.9); 16% met the criteria for moderate/severe Periodontal Disease. Among HIV+ non smokers, VitD Deficiency was associated with greater mCAL (p=0.049/β-coefficient=0.278) in multivariate models. Among HIV+ smokers, VitD Deficiency was only associated with mBI (p=0.002 β-coefficient=-0.329) in multivariate models. Conclusion: In HIV+ non smokers, VitD Deficiency was associated with more severe Periodontal Disease.