title: Urine Eicosanoids in the Metabolic Abnormalities, Telmisartan, and HIV Infection (MATH) Trial.
abstract: OBJECTIVE
  Arachidonic acid metabolites (eicosanoids) reflect oxidative stress and vascular health and have been associated with anthropometric measures and sex differences in cross-sectional analyses of HIV-infected (HIV+) persons. Telmisartan is an angiotensin receptor blocker and PPAR-γ agonist with potential anti-inflammatory and metabolic benefits. We assessed telmisartan's effects on urine eicosanoids among HIV+ adults with central adiposity on suppressive antiretroviral therapy enrolled in a prospective clinical trial.
  
  
  METHODS
  Thirty-five HIV+ adults (15 women; 20 men) completed 24 weeks of open-label oral telmisartan 40mg daily. Lumbar computed tomography quantified visceral (VAT) and subcutaneous (SAT) abdominal adipose tissue. Urine F2-isoprostane (F2-IsoP), prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane B2 (TxB-M) were quantified at baseline and 24 weeks using gas/liquid chromatography-mass spectroscopy. Mann-Whitney-U tests compared sub-group differences; Spearman's rho assessed correlations between clinical factors and eicosanoid levels.
  
  
  RESULTS
  Median PGE-M increased on telmisartan (p<0.01), with greater changes in men (+4.1 [p = 0.03] vs. +1.0 ng/mg cr in women; between-group p = 0.25) and participants losing >5% VAT (+3.7 ng/mg cr, p<0.01) and gaining >5% SAT (+1.7 ng/mg cr, p = 0.04). Median baseline F2-IsoP and TxB-M were slightly higher in women (both between-group p = 0.08) and did not change on telmisartan.
  
  
  CONCLUSIONS
  Urine PGE-M increased with 24 weeks of telmisartan in virally suppressed, HIV+ adults with central adiposity. Associations with favorable fat redistribution suggest increased PGE-M may reflect a beneficial response.
authors.affiliation: Vanderbilt University School of Medicine, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, United States of America.
authors.forename: Catherine N
authors.initials: CN
authors.lastname: Le
authors.affiliation: Vanderbilt University School of Medicine, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, United States of America.
authors.forename: Todd
authors.initials: T
authors.lastname: Hulgan
authors.affiliation: University of California-Los Angeles, Department of Medicine, Division of Infectious Disease, Los Angeles, California, United States of America.
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Vanderbilt University School of Medicine, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, United States of America.
authors.forename: Ginger L
authors.initials: GL
authors.lastname: Milne
authors.affiliation: University of California-Los Angeles, Department of Medicine, Division of Infectious Disease, Los Angeles, California, United States of America.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001562:Benzimidazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D050218:Body Fat Distribution; D015777:Eicosanoids / Q000652:urine*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology; D008060:Lipodystrophy / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D010865:Pilot Projects; D011446:Prospective Studies; D012737:Sex Factors; D000077333:Telmisartan; D049629:Waist-Hip Ratio
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D019380:Anti-HIV Agents; D001562:Benzimidazoles; D001565:Benzoates; D015777:Eicosanoids; D000077333:Telmisartan