Endocrinology and Nutrition Service, University General Hospital of Alicante, Alicante, Spain.
Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain.
Clin Endocrinol (Oxf). 2018 Oct;89(4):414-423. doi: 10.1111/cen.13800. Epub 2018 Jul 16.
HIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, nonalcoholic fatty liver disease (NAFLD) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV-infected males.
Cross-sectional study in a cohort of HIV-infected patients.
Inclusion criteria: men older than 18 years; antiretroviral therapy (ART) -naïve or on effective ART (<50 HIV-1 RNA copies/mL) without changes in the previous 6 months; no diabetes or hepatitis C.
Irisin was measured by enzymatic immunoassay (Phoenix Pharmaceuticals), insulin sensitivity by homeostasis model assessment of insulin resistance (HOMA-IR), as well as the 2-hour continuous infusion of glucose with model assessment (CIGMA-HOMA). Hepatic steatosis was measured by 1-H magnetic resonance spectroscopy, subclinical atherosclerosis by evaluation of carotid intima-media thickness (C-IMT), measured by Ultrasonography.
Eight nine men (age 42.0 ± 8.3 years, duration of HIV infection 7.9 ± 5.6 years, CD4 count 547 ± 279 cells/mL) were included. Circulating irisin was positively related to HOMA-IR and CIGMA-HOMA, hepatic triglyceride content, and to VAT/SAT ratio. Higher irisin concentrations were associated with higher C-IMT, although this association did not persist in multivariate analysis. Lipodystrophy and a higher baseline PAI-1 concentration were independently associated with C-IMT.
In male HIV patients without diabetes, higher irisin concentrations are positively associated with insulin resistance, NAFLD and subclinical atherosclerosis. However, waist-hip-ratio is the main determinant of insulin resistance, and PAI-1 and lipodystrophy were the strongest determinants of IMT in this population.
HIV 感染与心血管疾病风险增加相关。鸢尾素是一种由骨骼肌分泌的肌因子，可能影响胰岛素稳态、非酒精性脂肪性肝病（NAFLD）和动脉粥样硬化。我们的目的是评估 HIV 感染男性的血清鸢尾素、胰岛素稳态、NAFLD 和亚临床动脉粥样硬化之间的关系。
HIV 感染患者队列的横断面研究。
纳入标准：年龄大于 18 岁的男性；抗逆转录病毒治疗（ART）-初治或接受有效 ART（<50 HIV-1 RNA 拷贝/mL）且在过去 6 个月内未改变；无糖尿病或丙型肝炎。
用酶联免疫吸附法（凤凰制药公司）测定鸢尾素，用稳态模型评估胰岛素抵抗（HOMA-IR）测定胰岛素敏感性，以及用模型评估的 2 小时连续葡萄糖输注（CIGMA-HOMA）。用 1-H 磁共振波谱测定肝脂肪变性，用超声测量颈动脉内膜中层厚度（C-IMT）评估亚临床动脉粥样硬化。
纳入 89 名男性（年龄 42.0±8.3 岁，HIV 感染时间 7.9±5.6 年，CD4 计数 547±279 个细胞/mL）。循环鸢尾素与 HOMA-IR 和 CIGMA-HOMA、肝甘油三酯含量和 VAT/SAT 比值呈正相关。较高的鸢尾素浓度与较高的 C-IMT 相关，但这种相关性在多变量分析中并未持续存在。脂肪营养不良和较高的基线 PAI-1 浓度与 C-IMT 独立相关。
在无糖尿病的 HIV 男性患者中，较高的鸢尾素浓度与胰岛素抵抗、NAFLD 和亚临床动脉粥样硬化呈正相关。然而，腰围-臀围比是该人群胰岛素抵抗的主要决定因素，PAI-1 和脂肪营养不良是 IMT 的最强决定因素。
