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.
PLoS One. 2021 Feb 5;16(2):e0246131. doi: 10.1371/journal.pone.0246131. eCollection 2021.
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.
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.
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.
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.
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。
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。
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。
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。
