高甘油三酯血症腰围表型是人类免疫缺陷病毒感染患者亚临床动脉粥样硬化的危险因素

[Hypertriglyceridemic waist phenotype is a risk factor for subclinical atherosclerosis in human immunodeficiency virus-infected patients].

作者信息

Bernal Enrique, Marín Irene, Muñoz Angeles, Sabán José, Sarabia Francisco, García-Medina Ana, Vicente Tomas, Cano Alfredo

机构信息

Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario Reina Sofía, Murcia, Spain.

出版信息

Med Clin (Barc). 2012 Dec 1;139(13):561-5. doi: 10.1016/j.medcli.2012.03.037. Epub 2012 Sep 15.

DOI:10.1016/j.medcli.2012.03.037

PMID:22985869

Abstract

BACKGROUND AND OBJECTIVE

To study the association between hypertriglyceridemic waist phenotype and the presence of subclinical atherosclerosis in human immunodeficiency virus (HIV) infected patients.

PATIENTS AND METHODS

Cross sectional study. Hypertriglyceridemic waist phenotype was considered if the waist was ≥90cm and triglycerides ≥2.0mmol/l (178mg/dl) in men and ≥85cm and ≥1.5mmol/L (133mg/dl) in women, respectively. We used the intima-media thickness (IMT) to detect carotid subclinical atherosclerosis.

RESULTS

We analyzed 152 patients, of whom 128 (84.2%) were receiving antiretroviral therapy, 40.7% were receiving protease inhibitors and 38.1% were treated with non-nucleoside reverse transcriptase inhibitors. The prevalence of hypertriglyceridemic waist phenotype was 23.6% (95% confidence interval [CI] 16.8-30.3%). Patients with hypertriglyceridemic waist phenotype had higher cardiovascular risk according to the Framingham score (11.09 [7.6] vs 3.88 [4], P=0.001) and lipodystrophy (33.3 vs. 13.7%, P=0.032) and metabolic syndrome (69.4 vs. 1.9%, P<0.001) were more frequent. The IMT was elevated in 21 (13.8%) patients. Hypertriglyceridemic waist phenotype (odds ratio [OR] 4.66 [95%CI 1.05-20.6; P = 0.043]) and metabolic syndrome (OR 3.74 [95%CI 1.25-11.23; P = 0.018]) were independently associated with higher IMT.

CONCLUSIONS

The hypertriglyceridemic waist phenotype is a risk factor for subclinical atherosclerosis in HIV infected patients and it is useful to detect patients with lipodystrophy, metabolic syndrome and high cardiovascular risk.

摘要

背景与目的

研究高甘油三酯血症腰围表型与人类免疫缺陷病毒（HIV）感染患者亚临床动脉粥样硬化存在之间的关联。

患者与方法

横断面研究。如果男性腰围≥90cm且甘油三酯≥2.0mmol/l（178mg/dl），女性腰围≥85cm且甘油三酯≥1.5mmol/L（133mg/dl），则认为存在高甘油三酯血症腰围表型。我们使用内膜中层厚度（IMT）来检测颈动脉亚临床动脉粥样硬化。

结果

我们分析了152例患者，其中128例（84.2%）正在接受抗逆转录病毒治疗，40.7%正在接受蛋白酶抑制剂治疗，38.1%接受非核苷类逆转录酶抑制剂治疗。高甘油三酯血症腰围表型的患病率为23.6%（95%置信区间[CI]16.8 - 30.3%）。根据弗雷明汉评分，高甘油三酯血症腰围表型的患者心血管风险更高（11.09[7.6]对3.88[4]，P = 0.001），脂肪代谢障碍（33.3对13.7%，P = 0.032）和代谢综合征（69.4对1.9%，P < 0.001）更为常见。21例（13.8%）患者的IMT升高。高甘油三酯血症腰围表型（优势比[OR]4.66[95%CI 1.05 - 20.6；P = 0.043]）和代谢综合征（OR 3.74[95%CI 1.25 - 11.23；P = 0.018]）与较高的IMT独立相关。