非洲人感染 HIV 超过 5 年的动脉结构和功能：与内皮细胞激活和心血管风险标志物的纵向关系。
Arterial structure and function in Africans with HIV for > 5 years: longitudinal relationship with endothelial activation and cardiovascular risk markers.
机构信息
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Medical Research Council Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
出版信息
HIV Med. 2021 Sep;22(8):650-661. doi: 10.1111/hiv.13111. Epub 2021 May 5.
OBJECTIVES
We aimed to determine whether people with human immunodeficiency virus (PWHIV) have increased measures of arterial injury [carotid intima-media thickness (cIMT)] and large artery stiffness [carotid-femoral pulse wave velocity (cfPWV)] when compared with their counterparts without HIV, and whether baseline markers of endothelial activation and cardiovascular risk are associated with cIMT and cfPWV after 5 years.
METHODS
We matched 126 PWHIV from North West Province, South Africa, to 126 without HIV according to age, sex and locality. Cardiovascular risk and endothelial function markers [soluble intracellular adhesion molecule (ICAM-1) and soluble vascular cell adhesion molecule (VCAM-1)] were measured at baseline and cIMT and cfPWV at follow-up.
RESULTS
This study included 21.4% men. The use of antiretroviral therapy (ART) increased from 44.1% at baseline to 81.4% at follow-up. At follow-up, cIMT (P = 0.90) and cfPWV (P = 0.35) were similar in the groups. Despite elevated ICAM-1 and VCAM-1 in the PWHIV (all P < 0.001) at baseline, these markers did not associate with cIMT and cfPWV after 5 years. In multivariable-adjusted regression analysis, cIMT associated positively with age (β = 0.31, P = 0.002) and triglyceride: high-density lipoprotein-cholesterol (β = 0.23, P = 0.016) in PWHIV. Mean arterial pressure (MAP) (β = 0.28, P = 0.010) associated positively with cfPWV in the PWHIV. In the people without HIV, sex (β = 0.31, P = 0.004) and glycated haemoglobin (HbA1c) (β = 0.24, P = 0.026) associated with cIMT while age (β = 0.17, P = 0.049), sex (β = 0.29, P = 0.003), MAP (β = 0.31, P = 0.001) and HbA1c (β = 0.21, P = 0.041) associated positively with cfPWV.
CONCLUSIONS
Measures of arterial structure and function were similar in Africans with HIV and their age, sex and locality matched controls. Traditional cardiovascular risk markers rather than elevated endothelial activation at baseline were independently associated with cIMT and cfPWV over 5 years.
目的
我们旨在确定与未感染 HIV 的人群相比，艾滋病毒感染者（PWHIV）的动脉损伤（颈动脉内膜中层厚度[cIMT]）和大动脉僵硬（颈股脉搏波速度[cfPWV]）是否增加，并确定基线内皮激活和心血管风险标志物是否与 5 年后的 cIMT 和 cfPWV 相关。
方法
我们根据年龄、性别和地点，将来自南非西北省的 126 名 PWHIV 与 126 名未感染 HIV 的人相匹配。在随访时测量心血管风险和内皮功能标志物（可溶性细胞间黏附分子[ICAM-1]和可溶性血管细胞黏附分子[VCAM-1]），并测量 cIMT 和 cfPWV。
结果
本研究包括 21.4%的男性。抗逆转录病毒治疗（ART）的使用率从基线时的 44.1%增加到随访时的 81.4%。在随访时，两组的 cIMT（P=0.90）和 cfPWV（P=0.35）相似。尽管 PWHIV 中的 ICAM-1 和 VCAM-1 在基线时均升高（均 P<0.001），但在 5 年后，这些标志物与 cIMT 和 cfPWV 并无关联。在多变量调整的回归分析中，cIMT 与年龄呈正相关（β=0.31，P=0.002），与甘油三酯：高密度脂蛋白胆固醇（β=0.23，P=0.016）呈正相关。在 PWHIV 中，平均动脉压（MAP）（β=0.28，P=0.010）与 cfPWV 呈正相关。在未感染 HIV 的人群中，性别（β=0.31，P=0.004）和糖化血红蛋白（HbA1c）（β=0.24，P=0.026）与 cIMT 相关，而年龄（β=0.17，P=0.049）、性别（β=0.29，P=0.003）、MAP（β=0.31，P=0.001）和 HbA1c（β=0.21，P=0.041）与 cfPWV 呈正相关。
结论
在非洲的 HIV 感染者及其年龄、性别和地点相匹配的对照组中，动脉结构和功能的测量值相似。传统的心血管风险标志物，而不是基线时升高的内皮激活，与 5 年后的 cIMT 和 cfPWV 独立相关。
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