Zizza A, Guido M, Tumolo M R, De Donno A, Bagordo F, Grima P
National Research Council, Institute of Clinical Physiology, Campus Ecotekne, Lecce, Italy.
Department of Biological and Environmental Sciences and Technologies, Laboratory of Hygiene, University of the Salento, Lecce, Italy.
J Prev Med Hyg. 2017 Sep;58(3):E219-E224.
Cardiovascular Diseases (CD) have emerged as a leading cause of morbidity and mortality in HIV population. Some studies have reported higher carotid Intima Media Thickness (c-IMT), a measure of subclinical atherosclerosis (AT), in this cohort of patients.
Here, we evaluate the role of Hepatic Steatosis (HS) as likely marker for AT in 128 HIV-infected patients without hepatitis C infection. c-IMT has been detected non-invasively by carotid ultrasonography to assess the progression of AT. HS has been evaluated using a process based on vibration-controlled transient elastography (Fibroscan) by a novel ultrasonic controlled attenuation parameter (CAP). The cut-off value for defining the presence of significant HS was CAP > 259 dBm.
AT has been detected in 26 patients (20.3%), whereas steatosis of grade 2 (S2) in 31 (24.2%). The variables statistically related to AT were age, obesity, diabetes, hypertension and S2. In the multivariate analysis, AT was only associated (p < 0.001) with age and S2. The optimal cut-off value indicated by ROC curve for predicting AT was CAP > 250 dB/m.
Our results highlight the presence of AT in HIVinfected persons and its association with fatty liver disease; therefore, HS assessment in HIV population results crucial to predict AT and CD.
心血管疾病（CD）已成为艾滋病毒感染者发病和死亡的主要原因。一些研究报告称，在这组患者中，颈动脉内膜中层厚度（c-IMT）较高，这是亚临床动脉粥样硬化（AT）的一种测量指标。
在此，我们评估了肝脂肪变性（HS）作为128例无丙型肝炎感染的艾滋病毒感染者中AT的可能标志物的作用。通过颈动脉超声检查非侵入性地检测c-IMT，以评估AT的进展。使用基于振动控制瞬时弹性成像（Fibroscan）的方法，通过一种新型超声控制衰减参数（CAP）评估HS。定义显著HS存在的临界值为CAP > 259 dBm。
26例患者（20.3%）检测到AT，31例（24.2%）检测到2级脂肪变性（S2）。与AT有统计学关联的变量为年龄、肥胖、糖尿病、高血压和S2。在多变量分析中，AT仅与年龄和S2相关（p < 0.001）。ROC曲线表明预测AT的最佳临界值为CAP > 250 dB/m。
我们的结果突出了艾滋病毒感染者中AT的存在及其与脂肪性肝病的关联；因此，在艾滋病毒感染者中评估HS对于预测AT和CD至关重要。
