Hileman Corrilynn O, Longenecker Chris T, Carman Teresa L, Milne Ginger L, Labbato Danielle E, Storer Norma J, White Cynthia A, McComsey Grace A
MetroHealth Medical Center, Cleveland, OH, USA.
Antivir Ther. 2012;17(7):1345-9. doi: 10.3851/IMP2297. Epub 2012 Aug 9.
D-Dimer elevations have been associated with a striking increase in mortality in HIV-infected patients. However, D-Dimer has not been directly linked to endothelial dysfunction in HIV.
In this cross-sectional study, we used flow-mediated dilation (FMD) of the brachial artery to measure endothelial function and several biomarkers to measure systemic inflammation and coagulation activation in HIV-infected adults on stable antiretroviral therapy with HIV-1 RNA levels <400 copies/ml. Multivariable linear regression was used to model FMD by these markers, traditional cardiovascular risk factors and HIV-related characteristics.
Analysis included 98 subjects (88% male, median age 47.5 years, CD4(+) T-cells 578.5 cells/mm(3)); all on ART (52% on protease inhibitors). The only factors independently associated with FMD were D-Dimer and body mass index.
We show for the first time an independent association between D-Dimer and endothelial dysfunction in virologically suppressed, HIV-infected adults on stable antiretroviral therapy, potentially explaining the link between D-Dimer and mortality in HIV.
D - 二聚体升高与HIV感染患者死亡率显著增加有关。然而，D - 二聚体尚未与HIV患者的内皮功能障碍直接相关。
在这项横断面研究中，我们采用肱动脉血流介导的血管舒张功能（FMD）来测量内皮功能，并使用多种生物标志物来测量接受稳定抗逆转录病毒治疗且HIV - 1 RNA水平<400拷贝/ml的HIV感染成人的全身炎症和凝血激活情况。采用多变量线性回归分析这些标志物、传统心血管危险因素和HIV相关特征对FMD的影响。
分析纳入98名受试者（88%为男性，中位年龄47.5岁，CD4(+) T细胞计数为578.5个细胞/mm(3)）；均接受抗逆转录病毒治疗（52%使用蛋白酶抑制剂）。与FMD独立相关的唯一因素是D - 二聚体和体重指数。
我们首次表明，在接受稳定抗逆转录病毒治疗且病毒学得到抑制的HIV感染成人中，D - 二聚体与内皮功能障碍存在独立关联，这可能解释了D - 二聚体与HIV患者死亡率之间的联系。
