title: Altered relationship of plasma triglycerides to HDL cholesterol in patients with HIV/HAART-associated dyslipidemia: further evidence for a unique form of metabolic syndrome in HIV patients.
abstract: BACKGROUND
  Plasma triglycerides (TG) and HDL-C are inversely related in Metabolic Syndrome (MetS), due to exchange of VLDL-TG for HDL-cholesteryl esters catalyzed by cholesteryl ester transfer protein (CETP). We investigated the relationship of TG to HDL-C in highly-active antiretroviral drug (HAART)-treated HIV patients.
  
  
  METHODS
  Fasting plasma TG and HDL-C levels were compared in 179 hypertriglyceridemic HIV/HAART patients and 71 HIV-negative persons (31 normotriglyceridemic (NL) and 40 hypertriglyceridemic due to type IV hyperlipidemia (HTG)). CETP mass and activity were compared in 19 NL and 87 HIV/HAART subjects.
  
  
  RESULTS
  Among the three groups, a plot of HDL-C vs. TG gave similar slopes but significantly different y-intercepts (9.24±0.45, 8.16±0.54, 6.70±0.65, sqrt(HDL-C) for NL, HIV and HTG respectively; P<0.001); this difference persisted after adjusting HDL-C for TG, age, BMI, gender, glucose, CD4 count, viral load and HAART strata (7.18±0.20, 6.20±0.05 and 4.55±0.15 sqrt(HDL-C) for NL, HIV and HTG, respectively, P<0.001). CETP activity was not different between NL and HIV, but CETP mass was significantly higher in HIV (1.47±0.53 compared to 0.93±0.27μg/mL, P<0.0001), hence CETP specific activity was lower in HIV (22.67±13.46 compared to 28.46±8.24nmol/μg/h, P=0.001).
  
  
  CONCLUSIONS
  Dyslipidemic HIV/HAART patients have a distinctive HDL-C plasma concentration adjusted for TG. The weak inverse relationship between HDL-C and TG is not explained by altered total CETP activity; it could result from a non-CETP-dependent mechanism or a decrease in CETP function due to inhibitors of CETP activity in HIV patients' plasma.
authors.affiliation: Translational Metabolism Unit, Diabetes Research Center, Division of Diabetes, Endocrinology and Metabolism, Houston, TX, USA.
authors.forename: Catherine N
authors.initials: CN
authors.lastname: Vu
authors.forename: Raul
authors.initials: R
authors.lastname: Ruiz-Esponda
authors.forename: Eric
authors.initials: E
authors.lastname: Yang
authors.forename: Evelyn
authors.initials: E
authors.lastname: Chang
authors.forename: Baiba
authors.initials: B
authors.lastname: Gillard
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Pownall
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.forename: Ivonne
authors.initials: I
authors.lastname: Coraza
authors.forename: Ashok
authors.initials: A
authors.lastname: Balasubramanyam
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood* / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood* / Q000150:complications / Q000821:virology; D006801:Humans; D006953:Hyperlipoproteinemia Type IV / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000821:virology; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; C506642:CETP protein, human; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL; D014280:Triglycerides