Dale Sannisha K, Weber Kathleen M, Cohen Mardge H, Brody Leslie R
a Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA.
c Department of Psychological & Brain Sciences , Boston University , Boston , MA , USA.
AIDS Care. 2017 May;29(5):598-602. doi: 10.1080/09540121.2016.1241378. Epub 2016 Oct 13.
This study investigated the relationships among abuse, nocturnal levels of cortisol and norepinephrine (NE), and coronary heart disease (CHD) risk as measured by the Framingham risk score among women with human immunodeficiency virus (HIV). Participants (n = 53) from the Chicago Women's Interagency HIV Study (WIHS), a longitudinal prospective cohort study initiated in 1994, were enrolled in this study during 2012. At WIHS baseline and annual follow-up visits, women were asked about recent experiences of abuse. Summary variables captured the proportion of visits for which women reported recent (past 12 months) physical, sexual, and domestic abuse. Cortisol and NE were assayed in overnight urine samples and adjusted for creatinine levels. Recent abuse was not significantly associated with levels of cortisol, NE, or NE/cortisol ratio. However, higher NE/cortisol ratio was significantly related to higher CHD risk score, higher cortisol was significantly related to lower CHD risk score, and NE was not associated with CHD risk score. In addition, higher proportions of visits with recent sexual abuse, physical abuse, and domestic abuse were significantly related to higher CHD risk score. The association between abuse exposure and CHD risk in the context of HIV infection is likely complex and may involve dysregulation of multiple neurobiological systems. Future research is needed to better understand these relationships and prevention and intervention efforts are needed to address abuse among women with HIV.
本研究调查了在感染人类免疫缺陷病毒（HIV）的女性中，虐待、夜间皮质醇和去甲肾上腺素（NE）水平与通过弗雷明汉风险评分衡量的冠心病（CHD）风险之间的关系。来自芝加哥女性机构间HIV研究（WIHS）的参与者（n = 53），这是一项始于1994年的纵向前瞻性队列研究，于2012年纳入本研究。在WIHS基线和年度随访时，询问女性近期的虐待经历。汇总变量记录了女性报告近期（过去12个月）身体、性和家庭虐待的访视比例。在过夜尿液样本中检测皮质醇和NE，并根据肌酐水平进行调整。近期虐待与皮质醇水平、NE水平或NE/皮质醇比值无显著关联。然而，较高的NE/皮质醇比值与较高的CHD风险评分显著相关，较高的皮质醇与较低的CHD风险评分显著相关，而NE与CHD风险评分无关。此外，近期性虐待、身体虐待和家庭虐待访视比例较高与较高的CHD风险评分显著相关。在HIV感染背景下，虐待暴露与CHD风险之间的关联可能很复杂，可能涉及多个神经生物学系统的失调。需要未来的研究来更好地理解这些关系，并且需要开展预防和干预工作来解决HIV感染女性中的虐待问题。
