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HIV感染青年的动脉僵硬度及其与HIV相关变量的关联。

Arterial stiffness in HIV-infected youth and associations with HIV-related variables.

作者信息

Eckard Allison Ross, Raggi Paolo, Ruff Joshua H, O'Riordan Mary Ann, Rosebush Julia C, Labbato Danielle, Daniels Julie E, Uribe-Leitz Monika, Longenecker Christopher T, McComsey Grace A

机构信息

a Medical University of South Carolina , Charleston , SC , USA.

b Emory University School of Medicine , Atlanta , GA , USA.

出版信息

Virulence. 2017 Oct 3;8(7):1265-1273. doi: 10.1080/21505594.2017.1305533. Epub 2017 Mar 21.

Abstract

Children and young adults infected with HIV are at elevated risk for cardiovascular disease (CVD). However, scarce data exist on the utility of non-invasive methods to diagnose subclinical CVD, such as pulse wave velocity (PWV), a non-invasive measure of arterial stiffness. The objectives of this study were to assess the relationship of carotid-femoral PWV with subclinical atherosclerosis measured by carotid intima-media thickness (IMT), compare measurements to healthy controls, and evaluate variables associated with PWV in HIV-infected youth. One hundred and one 8-25 year-old subjects on stable antiretroviral therapy with low-level viremia or an undetectable HIV-1 RNA were enrolled, along with 86 healthy controls similar in age, sex and race. There was no significant difference in PWV between groups (median (Q1, Q3): 5.7 (5.2, 6.3) vs 5.7 (4.9, 6.5) m/s; P = 0.81). Among the HIV-infected subjects, PWV was positively correlated with both internal carotid artery (R = 0.31, P = 0.02) and carotid bulb IMT (R = 0.29, P = 0.01). In multivariable regression, only current alcohol consumption and systolic blood pressure were independently associated with PWV in the HIV-infected group (where current alcohol consumption and higher systolic blood pressure were associated with higher PWV); whereas, age, body mass index, and current marijuana use were associated with PWV in healthy controls. In this study of PWV in HIV-infected youth, measures of arterial stiffness were not different between subjects and controls. However, in HIV-infected youth, there was a significant association between PWV and carotid IMT, as well as between PWV and current alcohol consumption. Thus, PWV may have potential as a useful, non-invasive method to assess CVD risk in HIV-infected youth, but further investigation is needed.

摘要

感染艾滋病毒的儿童和青年患心血管疾病(CVD)的风险较高。然而,关于非侵入性方法诊断亚临床CVD的效用的数据稀缺,如脉搏波速度(PWV),这是一种测量动脉僵硬度的非侵入性方法。本研究的目的是评估颈动脉-股动脉PWV与通过颈动脉内膜中层厚度(IMT)测量的亚临床动脉粥样硬化之间的关系,将测量结果与健康对照进行比较,并评估与感染艾滋病毒青年的PWV相关的变量。招募了101名年龄在8 - 25岁、接受稳定抗逆转录病毒治疗且病毒血症水平低或HIV-1 RNA检测不到的受试者,以及86名年龄、性别和种族相似的健康对照。两组之间的PWV无显著差异(中位数(四分位数间距):5.7(5.2,6.3)与5.7(4.9,6.5)m/s;P = 0.81)。在感染艾滋病毒的受试者中,PWV与颈内动脉(R = 0.31,P = 0.02)和颈动脉球部IMT均呈正相关(R = 0.29,P = 0.01)。在多变量回归中,在感染艾滋病毒的组中,仅当前饮酒量和收缩压与PWV独立相关(当前饮酒量和较高的收缩压与较高的PWV相关);而在健康对照中,年龄、体重指数和当前使用大麻与PWV相关。在这项对感染艾滋病毒青年的PWV研究中,受试者和对照之间的动脉僵硬度测量值没有差异。然而,在感染艾滋病毒的青年中,PWV与颈动脉IMT之间以及PWV与当前饮酒量之间存在显著关联。因此,PWV可能有潜力作为一种有用的非侵入性方法来评估感染艾滋病毒青年的心血管疾病风险,但需要进一步研究。

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