Relationship of body composition, metabolic status, antiretroviral use, and HIV disease factors to endothelial dysfunction in HIV-infected subjects.
Vascular endothelial dysfunction may contribute to the increase in cardiovascular events during HIV-1 infection and its treatment. Antiretroviral therapy (ART), metabolic factors, lipodystrophy, and HIV infection itself may be involved. Ninety-six HIV-infected subjects were evaluated for endothelial function by measurement of brachial artery flow-mediated dilation (FMD) by ultrasound, single-slice CT of the abdomen and mid-thigh, whole-body dual x-ray absorptiomety (DXA) scans, and metabolic evaluations in a cross-sectional study. The median age was 40 years; 28% were female, 38% black, 3% Hispanic, and 59% white. Forty-nine (51%) were receiving ART, which included a PI in 28 (57%) and was non-PI based in 21 (43%). FMD (+/-SD) in subjects not on ART was 5.5 +/- 4.3%, PI-ART 5.3 +/- 3.6%, and non-PI-ART 5.5 +/- 4.1% (p = 0.9). Age, race, CD4 cell count, and HIV RNA did not correlate significantly with FMD. Among ART-treated subjects in the lowest tertile of thigh subcutaneous fat area (range 3-31 cm(2)), FMD was 4.4 +/- 3.5% and in the highest tertile (range 67-237 cm(2)) FMD was 6.8 +/- 3.6% (p = 0.07, t-test). However, in multivariate analyses, no body composition measure showed a significant association with FMD for either the group as a whole or in ART-treated subjects. ART use, PI use, CD4 cell count, and HIV RNA levels were not associated with endothelial dysfunction by brachial FMD. A definitive association with measures of adiposity was not detected in multivariate analysis, suggesting that lipoatrophy may not be an important contributor to endothelial dysfunction in HIV-infected individuals on ART.
Dubé
Michael P
MP
Department of Medicine and the Divisions of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA. mdube@usc.edu
Shen
Changyu
C
Mather
Kieren J
KJ
Waltz
Jeff
J
Greenwald
Martha
M
Gupta
Samir K
SK
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001823:Body Composition; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D008060:Lipodystrophy / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
D019380:Anti-HIV Agents