Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients.
OBJECTIVE
To assess the relationship between non-classical cardiovascular (CV) risk factors including non-HDL cholesterol (non-HDL-C), apolipoprotein B, triglycerides to HDL ratio, LDL size, inflammation or oxidative stress parameters and carotid intima-media thickness (CIMT), in order to better identify prevention or therapeutic targets. In addition, we studied the relationship between metabolic syndrome (MS) and CIMT.


METHODS
Cross-sectional study including 232 HIV-positive (HIV+) adults (80% treated by combined antiretroviral therapy) extracted from the ANRS CO3 Aquitaine Cohort.


RESULTS
There was a significant association of higher non-HDL-C (p<0.01), apolipoprotein B (p<0.01) levels or TG/HDL ratio (p<0.05) with higher CIMT when compared the first vs fourth quartile, while there is no association between CIMT and LDL-C (p=0.09) or LDL size (p=0.55). In multivariate analysis, only the TG/HDL molar ratio > 1.5 tend toward significance (p=0.08). MS was observed in only 7.3% of patients with the NCEP-ATP III definition and 11.2% with the IDF criteria. Whatever the used definition, there was a significant association between MS presence and increased CIMT (p<0.05) in univariate and multivariate model.


CONCLUSIONS
Non-HDL-C, TG/HDL ratio and apolipoprotein B levels, which are closely linked to lipid disorders associated to the MS, appear as stronger predictive markers than LDL-C for screening subclinical atherosclerosis in HIV+ populations. Achieving non-HDL-C target defined by the NCEP-ATP III guidelines appears of great importance to reduce CV complications in HIV+ patients.
Badiou
S
S
Biochemistry Department, University Hospital of Montpellier, F-34295 Montpellier, France.
Thiebaut
R
R
Aurillac-Lavignolle
V
V
Dabis
F
F
Laporte
F
F
Cristol
J P
JP
Mercie
P
P
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001055:Apolipoproteins B / Q000097:blood; D050197:Atherosclerosis / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D019380:Anti-HIV Agents; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D018894:Reverse Transcriptase Inhibitors; D014280:Triglycerides; D002784:Cholesterol