Micronutrient concentrations and subclinical atherosclerosis in adults with HIV.
BACKGROUND
Extremes in micronutrient intakes are common in HIV-infected patients in developed countries and may affect the progression of atherosclerosis in this population.


OBJECTIVE
We completed a cross-sectional study examining the association between serum micronutrient concentrations and surrogate markers of atherosclerosis in a cohort of HIV-infected adults.


METHODS
We measured serum selenium, zinc, vitamin A, and vitamin E concentrations as well as carotid intima-media thickness (c-IMT) and coronary artery calcium (CAC) in 298 Nutrition for Healthy Living participants. We assessed cardiovascular disease risk factors, c-IMT, and CAC for each micronutrient tertile by using a chi-square test for binary variables and analysis of variance for continuous variables. We performed multivariate regression of c-IMT and CAC with each micronutrient with adjustment for HIV-related and cardiovascular disease risk factors.


RESULTS
In the multivariate analysis, the highest tertile of serum vitamin E concentration was associated with higher common and internal c-IMT and CAC scores (P < 0.05 for c-IMT and CAC). Participants with higher vitamin E concentrations were more likely to have detectable CAC (50% compared with 44% compared with 67% for tertiles 1, 2, and 3, respectively; P = 0.004) and common c-IMT >0.8 mm (5% compared with 4% compared with 17% for tertiles 1, 2, and 3, respectively; P = 0.002). Other than vitamin E, micronutrients had no association with markers of atherosclerosis.


CONCLUSIONS
Our study showed that elevated serum vitamin E concentrations are associated with abnormal markers of atherosclerosis and may increase the risk of cardiovascular complications in HIV-infected adults.
Falcone
E Liana
EL
Department of Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA. efalcone@tuftsmedicalcenter.org
Mangili
Alexandra
A
Tang
Alice M
AM
Jones
Clara Y
CY
Woods
Margo N
MN
Polak
Joseph F
JF
Wanke
Christine A
CA
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D002339:Carotid Arteries / Q000378:metabolism / Q000473:pathology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008875:Middle Aged; D012643:Selenium / Q000097:blood; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D019562:Viral Load; D014801:Vitamin A / Q000097:blood*; D014810:Vitamin E / Q000097:blood*; D015032:Zinc / Q000097:blood
D008074:Lipoproteins; D018977:Micronutrients; D014801:Vitamin A; D014810:Vitamin E; D012643:Selenium; D015032:Zinc