Massachusetts General Hospital (MGH) Program in Nutritional Metabolism, Boston, MA 02114, USA.
AIDS. 2013 Jan 2;27(1):49-57. doi: 10.1097/QAD.0b013e328358b29c.
To investigate the effects of aging and smoking on carotid intima-media thickness (cIMT) among patients with and without HIV.
Data from a community sample of HIV-infected and HIV-uninfected participants were analyzed. Carotid intima-media thickness was measured via carotid ultrasound and smoking history was obtained via patient interview.
Data on 166 male and female participants with stable HIV-infection and 152 healthy HIV-uninfected participants were analyzed. Among the HIV-infected and HIV-uninfected participants, a significant association was observed between age and cIMT [r = 0.51, P < 0.0001 (HIV), r = 0.39, P < 0.0001, (non-HIV)], and between smoking burden and cIMT [r = 0.42, P < 0.0001 (HIV), r = 0.24, P = 0.003 (non-HIV)]. In multivariate regression modeling among all participants (HIV and non-HIV), a significant three-way interaction was observed between age, smoking burden, and HIV status with respect to cIMT (P < 0.010), controlling for sex, race, and traditional cardiovascular disease (CVD) risk factors, such that increased cIMT was associated with increased smoking burden and age to a greater degree among HIV-infected vs. HIV-uninfected participants. Among HIV-infected participants a significant interaction between smoking burden and age with respect to cIMT was seen (P = 0.027) controlling for race, sex, CVD risk factors, immunological function, and antiretroviral therapy use.
A significant interaction between HIV, age, and smoking on cIMT was observed, suggesting that HIV-infection modifies the relationship of age and smoking on cIMT in this population. These findings emphasize the need to encourage smoking cessation in this population, due to its deleterious effect on subclinical atherosclerosis in older HIV-infected patients.
探讨在 HIV 感染者和非感染者中，衰老和吸烟对颈动脉内膜-中层厚度（cIMT）的影响。
对来自社区的 HIV 感染者和非感染者的样本数据进行了分析。通过颈动脉超声测量颈动脉内膜-中层厚度，并通过患者访谈获得吸烟史。
对 166 名 HIV 感染稳定的男性和女性参与者以及 152 名健康的 HIV 未感染者的数据进行了分析。在 HIV 感染者和非感染者中，年龄与 cIMT 之间存在显著相关性[r = 0.51，P < 0.0001（HIV），r = 0.39，P < 0.0001（非 HIV）]，吸烟量与 cIMT 之间也存在显著相关性[r = 0.42，P < 0.0001（HIV），r = 0.24，P = 0.003（非 HIV）]。在所有参与者（HIV 和非 HIV）的多元回归模型中，年龄、吸烟量和 HIV 状态对 cIMT 的三因素相互作用显著（P < 0.010），控制了性别、种族和传统心血管疾病（CVD）危险因素，表明与非 HIV 感染者相比，HIV 感染者的 cIMT 与吸烟量和年龄的相关性更大。在 HIV 感染者中，吸烟量与年龄对 cIMT 的交互作用显著（P = 0.027），控制了种族、性别、CVD 危险因素、免疫功能和抗逆转录病毒治疗的使用。
在 cIMT 方面，HIV、年龄和吸烟之间存在显著的相互作用，表明 HIV 感染改变了该人群中年龄和吸烟对 cIMT 的关系。这些发现强调了在该人群中需要鼓励戒烟，因为吸烟对老年 HIV 感染者亚临床动脉粥样硬化有不良影响。
