title: Urinary albumin-to-creatinine ratio is associated with endothelial dysfunction in HIV-infected patients receiving antiretroviral therapy.
abstract: Endothelial dysfunction, a marker of cardiovascular (CV) risk, is common in human immunodeficiency virus (HIV)-infected patients. Microalbuminuria is frequent in HIV-infected patients, and is a predictor of renal impairment and CV risk. We investigated the association between microalbuminuria and endothelial dysfunction among HIV-infected patients receiving highly-active antiretroviral therapy (HAART). Endothelial function, measured by brachial artery flow-mediated dilatation (bFMD), and urine albumin-to-creatinine ratio (UACR), were measured in 170 HAART-treated HIV-infected adults. The relationship between UACR and bFMD was evaluated. The prevalence of increased UACR, defined by two cut-off levels (20 mg/g and 30 mg/g), was 29% and 17%. UACR was significantly higher while bFMD was lower among patients with metabolic syndrome (MS). UACR was associated with bFMD (r = -0.31; p < 0.001). This association was stronger in MS-patients (r = -0.44; p = 0.003). UACR above 20 mg/g was associated with an increased risk (OR 2.37, 95% CI 1.15-4.89, p = 0.020) of severely impaired bFMD (bFMD ≤ 2.1%). Patients with MS and increased UACR had the lowest bFMD compared with those with none or one of the two conditions. Microalbuminuria and endothelial dysfunction are positively associated in HIV-infected patients regardless of known confounders. The coexistence of microalbuminuria and MS amplifies their deleterious influence on endothelial function.
authors.affiliation: Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Pirro
authors.affiliation: Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Massimo R
authors.initials: MR
authors.lastname: Mannarino
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Francisci
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Schiaroli
authors.affiliation: Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bianconi
authors.affiliation: Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bagaglia
authors.affiliation: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.|Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
authors.affiliation: Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Elmo
authors.initials: E
authors.lastname: Mannarino
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Baldelli
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000652:urine*; D023241:Antiretroviral Therapy, Highly Active; D001916:Brachial Artery / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D003404:Creatinine / Q000652:urine*; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000652:urine*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D014664:Vasodilation
chemical_list: D003404:Creatinine