γ-谷氨酰转移酶与南非 HIV 感染者合并心血管代谢疾病的相关性研究。
Associations of gamma-glutamyl transferase with cardio-metabolic diseases in people living with HIV infection in South Africa.
机构信息
Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town and Durban, South Africa.
Department of Medicine, University of Cape Town, Cape Town, South Africa.
出版信息
PLoS One. 2021 Feb 5;16(2):e0246131. doi: 10.1371/journal.pone.0246131. eCollection 2021.
BACKGROUND
Gamma-glutamyl transferase (GGT) has recently been reported as a biomarker for cardiovascular (CVD) risk in general populations. We investigated the associations of GGT with cardio-metabolic diseases and CVD risk in South Africans living with HIV.
METHODS
In this cross-sectional study, HIV-infected adults were randomly recruited across 17 HIV clinics in the Western Cape Province. Homeostatic model assessment for insulin resistance (HOMA-IR), hypertension, diabetes, metabolic syndrome by Joint Interim Statement criteria (JIS-MS), a ≥5% and ≥10% predicted risk for a CVD event within 10 years by the Framingham risk score (10-years-CVD risk) were computed. Associations between GGT and cardio-metabolic trait were explored using linear and binomial logistic regressions adjusted for age, gender, lifestyle behaviours and HIV-related characteristics.
RESULTS
Among 709 participants (561 women, mean age 38.6 years), log-GGT was positively associated with waist circumference (β=2.75; p<0.001), diastolic blood pressure (β=1.65; p=0.006), total cholesterol (β=0.21; p<0.001), low-density lipoprotein-cholesterol (β=0.16; p<0.001), high-density lipoprotein-cholesterol and log-triglycerides (both β=0.12; p<0.001), fasting plasma glucose (β=0.19; p=0.031), 2-hour-post-glucose-load plasma glucose (β=0.26; p=0.007), HOMA-IR (β=0.13; p=0.001), log-high-sensitivity C-reactive-protein (β=0.3; p<0.001) in linear regression analyses; with hypertension [OR=1.41 (95%CI, 1.13-1.75); p=0.001], JIS-MS [OR=1.33 (1.05-1.68); p=0.016], ≥5% 10-year-CVD risk [OR=1.55 (1.24-1.9400); p<0.001] and ≥10% 10-year-CVD risk [OR=1.56 (1.08-2.23); p=0.016] but not with diabetes [OR=1.24 (0.88-1.71), p=0.205] in logistic regression analyses.
CONCLUSIONS
In this study, GGT levels were associated with cardio-metabolic variables independent of HIV specific attributes. If confirmed in longitudinal studies, GGT evaluation maybe included in CVD risk monitoring strategies in people living with HIV.
背景
γ-谷氨酰转移酶（GGT）最近被报道为一般人群心血管（CVD）风险的生物标志物。我们研究了 GGT 与南非 HIV 感染者的心脏代谢疾病和 CVD 风险之间的关系。
方法
在这项横断面研究中，我们在西开普省的 17 个 HIV 诊所随机招募了 HIV 感染者。使用稳态模型评估胰岛素抵抗（HOMA-IR）、高血压、糖尿病、联合临时声明标准（JIS-MS）定义的代谢综合征、10 年内弗雷明汉风险评分（10 年-CVD 风险）预测 CVD 事件的≥5%和≥10%风险，计算了这些指标。使用线性和二项逻辑回归，在调整年龄、性别、生活方式行为和 HIV 相关特征后，探索 GGT 与心脏代谢特征之间的关系。
结果
在 709 名参与者（561 名女性，平均年龄 38.6 岁）中，log-GGT 与腰围（β=2.75；p<0.001）、舒张压（β=1.65；p=0.006）、总胆固醇（β=0.21；p<0.001）、低密度脂蛋白胆固醇（β=0.16；p<0.001）、高密度脂蛋白胆固醇和 log-甘油三酯（均β=0.12；p<0.001）、空腹血糖（β=0.19；p=0.031）、餐后 2 小时血糖（β=0.26；p=0.007）、HOMA-IR（β=0.13；p=0.001）、log-高敏 C 反应蛋白（β=0.3；p<0.001）呈正相关，在线性回归分析中；高血压[比值比（OR）=1.41（95%置信区间，1.13-1.75）；p=0.001]、JIS-MS[OR=1.33（1.05-1.68）；p=0.016]、≥5%10 年-CVD 风险[OR=1.55（1.24-1.9400）；p<0.001]和≥10%10 年-CVD 风险[OR=1.56（1.08-2.23）；p=0.016]，但不包括糖尿病[OR=1.24（0.88-1.71），p=0.205]，在逻辑回归分析中。
结论
在这项研究中，GGT 水平与心脏代谢变量相关，与 HIV 特定属性无关。如果在纵向研究中得到证实，GGT 评估可能会被纳入 HIV 感染者的 CVD 风险监测策略中。
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