Hall Leangelo N, Sanchez Laura R, Hubbard Jane, Lee Hang, Looby Sara E, Srinivasa Suman, Zanni Markella V, Stanley Takara L, Lo Janet, Grinspoon Steven K, Fitch Kathleen V
Harvard Medical School, Boston, Massachusetts.
Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston.
Open Forum Infect Dis. 2017 Apr 24;4(2):ofx083. doi: 10.1093/ofid/ofx083. eCollection 2017 Spring.
Dietary sweeteners may contribute to metabolic dysregulation and cardiovascular disease (CVD), but this has not been assessed in human immunodeficiency virus (HIV).
One hundred twenty-four HIV-infected and 56 non-HIV-infected participants, without history of known coronary artery disease were included. Dietary intake was assessed using a 4-day food record. Coronary plaque was determined using cardiac computed tomography angiography.
Human immunodeficiency virus-infected participants had significantly greater intake of dietary sweeteners, including total sugar ( = .03) and added sugar ( = .009); intake of aspartame (artificial sweetener) was greater among aspartame consumers with HIV versus non-HIV consumers ( = .03). Among HIV-infected participants, aspartame intake was significantly associated with coronary plaque ( = .002) and noncalcified plaque ( = .007) segments, as well as markers of inflammation/immune activation (monocyte chemoattractant protein 1 and lipoprotein-associated phospholipase A), which may contribute to increased atherogenesis. In multivariable regression modeling, aspartame remained an independent predictor of plaque in HIV. In contrast, among non-HIV-infected participants, no sweetener type was shown to relate to plaque characteristics.
We demonstrate increased intake of dietary sweeteners and a potential novel association between aspartame intake, plaque burden, and inflammation in HIV. Our data suggest that aspartame may contribute to CVD risk in HIV. Further studies should address potential mechanisms by which aspartame may contribute to increased plaque burden and cardiovascular benefits of dietary strategies targeting aspartame intake in HIV.
膳食甜味剂可能导致代谢失调和心血管疾病（CVD），但尚未在人类免疫缺陷病毒（HIV）感染者中进行评估。
纳入124名感染HIV且无已知冠状动脉疾病史的参与者以及56名未感染HIV的参与者。通过4天食物记录评估膳食摄入量。使用心脏计算机断层扫描血管造影术确定冠状动脉斑块。
感染HIV的参与者膳食甜味剂摄入量显著更高，包括总糖（P = 0.03）和添加糖（P = 0.009）；与未感染HIV的阿斯巴甜消费者相比，感染HIV的阿斯巴甜消费者中阿斯巴甜（人工甜味剂）摄入量更高（P = 0.03）。在感染HIV的参与者中，阿斯巴甜摄入量与冠状动脉斑块（P = 0.002）和非钙化斑块（P = 0.007）节段以及炎症/免疫激活标志物（单核细胞趋化蛋白1和脂蛋白相关磷脂酶A）显著相关，这可能导致动脉粥样硬化增加。在多变量回归模型中，阿斯巴甜仍然是HIV感染者斑块的独立预测因子。相比之下，在未感染HIV的参与者中，未显示任何甜味剂类型与斑块特征有关。
我们证明了HIV感染者膳食甜味剂摄入量增加，以及阿斯巴甜摄入量、斑块负担和炎症之间潜在的新关联。我们的数据表明，阿斯巴甜可能增加HIV感染者患心血管疾病的风险。进一步的研究应探讨阿斯巴甜可能导致斑块负担增加的潜在机制，以及针对HIV感染者阿斯巴甜摄入量的饮食策略对心血管的益处。
