title: Ultrasound measurements of carotid intima-media thickness and plaque in HIV-infected patients on the Mediterranean diet.
abstract: OBJECTIVE
  To evaluate the influence of food habits, specifically adherence to the Mediterranean diet, on carotid intima-media thickness (CIMT) and the presence of plaques in HIV-infected patients taking antiretroviral therapy (ART) and non-HIV-infected participants and to determine if HIV infection contributes independently to subclinical atherosclerosis.
  
  
  METHODS
  We conducted a cross-sectional study of 110 HIV-infected patients on ART and 131 non-HIV-infected participants at the University Hospital for Infectious Diseases in Zagreb, Croatia, from 2009-2011. CIMT measurement and determination of carotid plaque presence was detected by ultrasound. Adherence to the Mediterranean diet was assessed by a 14-point food-item questionnaire. Subclinical atherosclerosis was defined by CIMT≥0.9 mm or ≥1 carotid plaque.
  
  
  RESULTS
  In HIV-infected patients, subclinical atherosclerosis was associated with older age (Plt;0.001; Mann-Whitney test), higher body mass index (P=0.051; Mann-Whitney test), hypertension (Plt;0.001; χ(2) test), and a lower Mediterranean diet score (P=0.035; Mann-Whitney test), and in non-HIV-infected participants with older age (P lt; 0.001; Mann-Whitney test) and hypertension (P=0.006; χ(2) test). Multivariate analysis showed that decreased adherence to the Mediterranean diet was associated with higher odds of subclinical atherosclerosis (odds ratio [OR] 2.28, 95% confidence interval [CI] 1.10-4.72, P=0.027) as was current smoking (OR 2.86, 95% CI 1.28-6.40), hypertension (OR 3.04, 95% CI 1.41-6.57), and male sex (OR 2.35, 95% CI 0.97-5.70). There was a significant interaction of age and HIV status, suggesting that older HIV-infected patients had higher odds of subclinical atherosclerosis than controls (OR 3.28, 95% CI 1.24-8.71, P=0.017 at the age of 60 years).
  
  
  CONCLUSIONS
  We confirmed the association between lower adherence to the Mediterranean diet and increased risk of subclinical atherosclerosis and found that treated HIV infection was a risk factor for subclinical atherosclerosis in older individuals.
authors.affiliation: Klaudija Viskovic, Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, 10 000 Zagreb, Croatia, viskovick@gmail.com.
authors.forename: Klaudija
authors.initials: K
authors.lastname: Višković
authors.forename: George W
authors.initials: GW
authors.lastname: Rutherford
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sudario
authors.forename: Lorna
authors.initials: L
authors.lastname: Stemberger
authors.forename: Zoran
authors.initials: Z
authors.lastname: Brnić
authors.forename: Josip
authors.initials: J
authors.lastname: Begovac
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000000981:diagnostic imaging*
chemical_list: D019380:Anti-HIV Agents