Jung Molly, Parrinello Christina M, Xue Xiaonan, Mack Wendy J, Anastos Kathryn, Lazar Jason M, Selzer Robert H, Shircore Anne M, Plankey Michael, Tien Phyllis, Cohen Mardge, Gange Stephen J, Hodis Howard N, Kaplan Robert C
Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY (M.J., X.X., K.A., R.C.K.).
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.P., S.J.G.).
J Am Heart Assoc. 2015 Feb 19;4(2):e001405. doi: 10.1161/JAHA.114.001405.
Adults infected with HIV have increased atherosclerosis potentially associated with both HIV and non-HIV associated factors. We characterized risk factors for atherosclerosis as measured by noninvasive vascular imaging.
We used B-mode ultrasound to examine levels and correlates of echogenicity and vessel wall thickness of the carotid artery intima-media complex in 1282 HIV-infected and 510 HIV-uninfected women of the Women's Interagency HIV Study. Levels of gray scale median (GSM, a measure of echogenicity) did not vary between HIV infection groups. In both groups, smokers had increased GSM, whereas age, diabetes, elevated blood pressure, and high BMI were associated with lower (rather than higher) GSM. Each of these non-lipid CVD risk factors, especially age and blood pressure, was also associated with higher levels of carotid artery intima-media thickness (cIMT). Higher serum triglyceride levels were associated with lower GSM in both HIV-infected and HIV-uninfected groups. Additional lipid risk factors for low GSM including high LDL cholesterol and low HDL cholesterol levels were identified in HIV uninfected but not in HIV infected women. In contrast to findings for GSM, among the lipid parameters only LDL cholesterol level had an association with cIMT, which was observed only in the HIV uninfected group.
Lipid and non-lipid risk factor associations with echolucency of the carotid artery and the thickness of the common carotid artery intima-media layer suggest that these measures capture different aspects of atherosclerosis.
感染HIV的成年人动脉粥样硬化风险增加，这可能与HIV及非HIV相关因素有关。我们通过无创血管成像来确定动脉粥样硬化的危险因素。
我们使用B型超声检查了女性机构间HIV研究中1282名感染HIV和510名未感染HIV的女性的颈动脉内膜中层复合体的回声强度水平及其相关因素，以及血管壁厚度。HIV感染组之间的灰度中位数（GSM，一种回声强度测量指标）水平没有差异。在两组中，吸烟者的GSM增加，而年龄、糖尿病、血压升高和高BMI与较低（而非较高）的GSM相关。这些非脂质心血管疾病危险因素中的每一个，尤其是年龄和血压，也与较高的颈动脉内膜中层厚度（cIMT）相关。在感染HIV和未感染HIV的组中，较高的血清甘油三酯水平都与较低的GSM相关。在未感染HIV的女性中发现了导致低GSM的其他脂质危险因素，包括高LDL胆固醇和低HDL胆固醇水平，但在感染HIV的女性中未发现。与GSM的结果相反，在脂质参数中，只有LDL胆固醇水平与cIMT相关，且仅在未感染HIV的组中观察到这种关联。
脂质和非脂质危险因素与颈动脉的透声性以及颈总动脉内膜中层厚度的关联表明，这些测量方法反映了动脉粥样硬化的不同方面。
