Margossian, ReneeWilliams, Paige L.Yu, WendyJacobson, Denise L.Geffner, Mitchell E.DiMeglio, Linda A.Van Dyke, Russell B.Spector, Stephen A.Schuster, Gertrud U.Stephensen, Charles B.Miller, Tracie L.Lipshultz, Steven E.Study (PHACS) for the Pediatric HIV/AIDS Cohort2020-11-042020-11-042020-06-01Margossian, R., Williams, P. L., Yu, W., Jacobson, D. L., Geffner, M. E., DiMeglio, L. A., Van Dyke, R. B., Spector, S. A., Schuster, G. U., Stephensen, C. B., Miller, T. L., Lipshultz, S. E., & Study (PHACS), for the P. H. C. (2019). Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents. JAIDS Journal of Acquired Immune Deficiency Syndromes, 81(2), 238–246. https://doi.org/10.1097/QAI.00000000000020071525-4135https://hdl.handle.net/1805/24265Background: Disordered bone mineral metabolism and low vitamin D concentrations are associated with cardiovascular abnormalities; few studies have evaluated this relationship in HIV-infected youth. Setting: Adolescent Master Protocol (AMP) is a Pediatric HIV/AIDS Cohort Study (PHACS) network study conducted across 14 United States sites. Methods: Among perinatally HIV-infected (PHIV) and HIV-exposed uninfected (PHEU) youth enrolled in AMP, we evaluated associations of vitamin D (measured as 25-hydroxyvitamin D [25OHD]), parathyroid hormone (PTH), calcium, phosphate, and fibroblast growth factor-23 (FGF-23) concentrations with echocardiographic measures of left ventricular (LV) structure, function and concentrations of NT-proBNP, a biomarker of cardiac damage. Results: Among 485 participants (305 PHIV, 180 PHEU) with echocardiograms and bone mineralization measures, low 25OHD (< 20 ng/mL) was common among all participants (48% PHIV and 44% PHEU), but elevated PTH (> 65 pg/mL) was identified more often among PHIV than PHEU participants (9% vs 3%, p=0.02). After adjusting for HIV status and demographic covariates, both low 25OHD and elevated PTH were associated with lower mean LV mass z-scores, while elevated PTH was associated with higher mean fractional shortening z-scores. Participants with low 25OHD also had slightly higher mean LV end-systolic wall stress z-scores, but differences were more pronounced in PHEU than in PHIV participants. FGF-23 was inversely related to end-diastolic septal thickness both overall and among PHIV participants. Conclusion: In this cohort of PHIV and PHEU youth, we observed associations of 25OHD, PTH, and FGF-23 with both structural and functional cardiac parameters, supporting links between bone mineral metabolism and cardiac status.25-hydroxy-vitamin Dparathyroid hormonecardiac functionHIV infectionchildrenArticle