Association of Atherogenic Combined Index, hs-CRP/HDL-C Ratio, and TC/ HDL-C-BMI Index with Low Vitamin D Levels among PLWH on Antiretroviral Therapy: A Cross-Sectional Study in Southwestern Uganda

Abstract

Background: Low Vitamin D levels are prevalent among people living with HIV (PLWH) on antiretroviral therapy (ART) and are associated with dyslipidemia and cardiovascular risk. This study examined the association between atherogenic indices and low vitamin D levels among PLWH in Southwestern Uganda. Methods: We conducted a cross-sectional study among 218 randomly selected PLWH who had been on ART for ≥6 months at Mbarara City Health Centre IV, Southwestern Uganda from August 13, 2024 to August 23, 2024. Low serum Vitamin D level was defined as serum 25-hydroxyvitamin D concentration <30 ng/mL. Results: Atherogenic combined index (ACI), high-sensitivity C-reactive protein (hs-CRP)/HDL-C ratio, and total chol esterol to high density lipoprotein cholesterol– body mass index (TC/HDL-C-BMI) index were independently asso ciated with low vitamin D. Compared to the first tertile, ACI second and third tertiles had higher likelihood of low vitamin D (aPR = 2.23, 95% confidence interval (CI): 1.28-3.89, P=0.005; aPR = 2.53, 95% CI: 1.05-6.05, P= 0.023). The high-sensitivity C-reactive protein to high-density lipoprotein cholesterol (hs-CRP/HDL-C) ratio third tertile was also significant (aPR = 1.44, 95% CI: 1.05-1.96, P=0.024). TC/HDL-C-BMI index third tertile showed nearly twice the prevalence (aPR = 1.95, 95% CI: 1.10-3.45, P=0.023). Conclusion: ACI, hs-CRP/HDL-C ratio, and TC/HDL-C-BMI index are potential predictors for Low serum Vitamin D levels among PLWH.