Swanson Barbara, Sha Beverly E, Keithley Joyce K, Fogg Louis, Nerad Judith, Novak Richard, Adeyemi Oluwatoyin
Rush University College of Nursing, Chicago, Illinois.
J Clin Lipidol. 2009 Dec 1;3(6):379-384. doi: 10.1016/j.jacl.2009.10.005.
HIV infection is associated with dyslipidemia and increased risk for cardiovascular events. Few studies have described lipid status in medically-underserved, HIV-infected ethnic minorities, a group that is characterized by health disparities. OBJECTIVE: The objective was to characterize the lipid profile of a medically-underserved, largely ethnic minority sample of HIV-infected persons using standard lipid panels and nuclear magnetic resonance (NMR) -derived lipoprotein particle profiles. METHODS: Participants were recruited from a randomized controlled trial of a dietary supplement to manage HIV-related dyslipidemia (N=132). At the initial screening visit, sociodemographic, clinical, and behavioral data were collected, and fasting peripheral venous blood specimens were obtained and lipid status was analyzed using the standard lipid panel and the NMR-derived lipoprotein particle profile. RESULTS: Using NMR-derived LDL particle cutoffs, a higher percentage of participants was outside the target range (50%) than when standard LDL cholesterol NCEP cutoffs were used (24%). Antiretroviral therapy, especially protease inhibitor-containing regimens, was associated with higher LDL particle concentration. CONCLUSION: Substantial numbers of medically-underserved, asymptomatic HIV-infected minorities may be at increased risk for CHD based on NMR-derived lipoprotein values.
HIV感染与血脂异常及心血管事件风险增加相关。很少有研究描述医疗服务不足的HIV感染少数族裔的血脂状况,这一群体存在健康差异。目的:使用标准血脂检测指标和基于核磁共振(NMR)的脂蛋白颗粒谱来描述医疗服务不足、主要为少数族裔的HIV感染者样本的血脂谱特征。方法:参与者来自一项用于管理HIV相关血脂异常的膳食补充剂随机对照试验(N = 132)。在初次筛查访视时,收集社会人口学、临床和行为数据,获取空腹外周静脉血标本,并使用标准血脂检测指标和基于NMR的脂蛋白颗粒谱分析血脂状况。结果:使用基于NMR的低密度脂蛋白(LDL)颗粒临界值时,超出目标范围的参与者百分比(50%)高于使用标准LDL胆固醇NCEP临界值时(24%)。抗逆转录病毒疗法,尤其是含蛋白酶抑制剂的治疗方案,与较高的LDL颗粒浓度相关。结论:基于NMR得出的脂蛋白值,大量医疗服务不足、无症状的HIV感染少数族裔可能患冠心病的风险增加。