Bongiovanni M, Casana M, Cicconi P, Pisacreta M, Codemo R, Pelucchi M, d'Arminio Monforte A, Bini T
Department of Medicine, Surgery and Dentistry, Institute of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Via di Rudinì 8, 20142 Milan, Italy.
J Antimicrob Chemother. 2008 Jan;61(1):195-9. doi: 10.1093/jac/dkm414. Epub 2007 Nov 12.
The predictive factors of intima media thickness (IMT) in the HIV-infected population are still poorly understood.
We studied three groups of subjects, aged 30-50 years, to find potential predictive factors of carotid and/or femoral thickening (IMT > 1 mm in at least one area): healthy controls (G1, n = 54), HIV-infected naive (G2, n = 53) and highly active antiretroviral treatment (HAART)-treated subjects (G3, n = 133). All the subjects underwent ultrasonography of the carotid and femoral vessels to evaluate IMT.
Demographic characteristics of the three groups were comparable, except for gender (G1 had a higher percentage of females) and lipid levels (higher in G3). A total of 115 subjects (47.9%) had carotid and/or femoral IMT: 26 in G1 (48.1%), 21 in G2 (39.6%) and 68 in G3 (51.1%). Independent predictive factors of carotid and/or femoral IMT were older age (OR: 2.81, 95% CI: 1.95-4.04, P < 0.01, for each additional 5 years), triglycerides >or=150 mg/dL (OR: 2.66, 95% CI: 1.27-5.57, P < 0.001), serum glucose >or=110 mg/dL (OR: 5.24, 95% CI: 1.02-27.05, P = 0.04), high homocysteinaemia (OR: 2.75, 95% CI: 1.17-6.46, P = 0.02) and high body mass index (OR: 1.10, 95% CI: 1-1.22, P = 0.05 for each additional unit); females had a lower risk (OR: 0.38, 95% CI: 0.18-0.79, P < 0.01 versus males). HAART use was not associated with IMT (OR: 0.64, 95% CI: 0.27-1.53, P = 0.32 and OR: 0.80, 95% CI: 0.30-2.13, P = 0.20 for G3 and G2 versus G1, respectively).
This study demonstrates that traditional risk factors for cardiovascular diseases overshadow the role of HAART in determining premature vascular lesions.
人们对HIV感染人群中内膜中层厚度（IMT）的预测因素仍知之甚少。
我们研究了三组年龄在30至50岁之间的受试者，以寻找颈动脉和/或股动脉增厚（至少一个区域的IMT>1mm）的潜在预测因素：健康对照组（G1，n = 54）、未接受过抗逆转录病毒治疗的HIV感染者（G2，n = 53）和接受高效抗逆转录病毒治疗（HAART）的受试者（G3，n = 133）。所有受试者均接受了颈动脉和股动脉血管超声检查以评估IMT。
除性别（G1组女性比例较高）和血脂水平（G3组较高）外，三组的人口统计学特征具有可比性。共有115名受试者（47.9%）出现颈动脉和/或股动脉IMT：G1组26名（48.1%），G2组21名（39.6%），G3组68名（51.1%）。颈动脉和/或股动脉IMT的独立预测因素包括年龄较大（每增加5岁，OR：2.81，95%CI：1.95 - 4.04，P < 0.01）、甘油三酯≥150mg/dL（OR：2.66，95%CI：1.27 - 5.57，P < 0.001）、血清葡萄糖≥110mg/dL（OR：5.24，95%CI：1.02 - 27.05，P = 0.04）、高同型半胱氨酸血症（OR：2.75，95%CI：1.17 - 6.46，P = 0.02）和高体重指数（每增加一个单位，OR：1.10，95%CI：1 - 1.22，P = 0.05）；女性风险较低（与男性相比，OR：0.38，95%CI：0.18 - 0.79，P < 0.01）。使用HAART与IMT无关（G3组与G1组相比，OR：0.64，95%CI：0.27 - 1.53，P = 0.32；G2组与G1组相比，OR：0.80，95%CI：0.30 - 2.13，P = 0.20）。
本研究表明，心血管疾病的传统危险因素在决定过早血管病变方面比HAART的作用更显著。
