Department of Immunology, Faculty of Health Sciences, National Health Laboratory Service and University of Witwatersrand, Johannesburg, South Africa.
Department of Molecular Medicine and Haematology, Faculty of Health Sciences, National Health Laboratory Service and University of Witwatersrand, Johannesburg, South Africa.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619883944. doi: 10.1177/1076029619883944.
People with HIV (PWH) have an increased prevalence of cardiovascular disease (CVD) compared to uninfected patients. Lipoprotein-associated phospholipase A (Lp-PLA) catalyzes the synthesis of pro-inflammatory lipids that recruit monocytes. Current guidelines for assessing cardiovascular risk in HIV-infected patients suggest that Lp-PLA may be a useful surrogate marker for CVD health in this patient population. Lipoprotein-associated phospholipase A, lipids, glucose, physical parameters, and carotid intimal-medial thickness (CIMT) were measured in 98 participants (49 HIV-uninfected, 27 antiretroviral therapy [ART]-naive PWH, and 22 ART-treated PWH). HIV viral load (VL) and CD4+ T-cell count were measured in HIV-infected participants. Lipoprotein-associated phospholipase A was increased in participants on protease inhibitor (PI) ART (median 50.5 vs 127.0 nmol/mL, = .05) and correlated with age, body mass index, and cholesterol. Lipoprotein-associated phospholipase A was not related to Framingham risk score or CIMT but correlated directly with VL ( = .323, = .025) and inversely with CD4+ T-cell count ( = -.727, < .001). Lipoprotein-associated phospholipase A was increased in HIV-infected participants on PIs and correlated strongly with VL and CD4+ T-cell count suggesting that HIV-associated inflammation is linked to increased Lp-PLA, providing a mechanistic link between HIV and CVD.
与未感染患者相比，HIV 感染者（PWH）患心血管疾病（CVD）的风险更高。脂蛋白相关磷脂酶 A（Lp-PLA）可催化合成募集单核细胞的促炎脂质。目前评估 HIV 感染者心血管风险的指南表明，Lp-PLA 可能是该患者人群 CVD 健康的有用替代标志物。在 98 名参与者（49 名 HIV 未感染者、27 名未接受抗逆转录病毒治疗（ART）的 PWH 和 22 名接受 ART 治疗的 PWH）中测量了脂蛋白相关磷脂酶 A、脂质、葡萄糖、身体参数和颈动脉内膜中层厚度（CIMT）。在 HIV 感染者中测量了 HIV 病毒载量（VL）和 CD4+ T 细胞计数。接受蛋白酶抑制剂（PI）ART 的参与者的脂蛋白相关磷脂酶 A 增加（中位数 50.5 与 127.0 nmol/mL，.05），并与年龄、体重指数和胆固醇相关。脂蛋白相关磷脂酶 A 与 Framingham 风险评分或 CIMT 无关，但与 VL 呈直接相关（ =.323，.025），与 CD4+ T 细胞计数呈负相关（ = -.727，.001）。接受 PI 的 HIV 感染者的脂蛋白相关磷脂酶 A 增加，与 VL 和 CD4+ T 细胞计数呈强相关，表明 HIV 相关炎症与 Lp-PLA 增加有关，为 HIV 和 CVD 之间的关联提供了一种机制联系。
