Rønn Christian, Knudsen Andreas Dehlbæk, Arentoft Nicoline Stender, Thudium Rebekka Faber, Heidari Safura-Luise, Sivapalan Pradeesh, Ulrik Charlotte S, Benfield Thomas, Ostrowski Sisse Rye, Jensen Jens Ulrik Stæhr, Nielsen Susanne D
Section of Respiratory Medicine, Department of Medicine, Copenhagen University Hospital - Gentofte, Hellerup, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Front Med (Lausanne). 2024 Jul 24;11:1337609. doi: 10.3389/fmed.2024.1337609. eCollection 2024.
Endothelial injury may promote declining lung function. We aimed to investigate in well-treated persons living with HIV (PLWH) whether elevated levels of thrombomodulin (TM) and syndecan-1 (SDC1) are associated with excess lung function decline and worsening dyspnea.
A prospective cohort study comprising patients from the Copenhagen municipality. We included 698 PLWH with undetectable viral load. Biomarkers and demographics were measured at baseline, spirometry [forced expiratory volume in one second (FEV) and forced vital capacity (FVC)] and dyspnea score both at baseline and 2-year follow-up.Both biomarkers were dichotomized at the 3rd quartile. Decline in lung function was estimated using a linear mixed model with patient-specific random effect. Increase in dyspnea score was estimated using a general mixed logistic regression model.
We did not find an association between elevated SDC1 or TM and an excess decline in neither FEV: SDC1: 4.5 mL/year (95% CI: -3.9-12.9, = 0.30), TM: 2.2 mL/year (95% CI: -6.0-10.4, = 0.60) nor FVC: SDC1: 4.1 mL/year (95% CI: -6.0-14.2, = 0.42), TM: 1.4 mL/year (95% CI: -8.3-11.1, = 0.78). A subgroup analysis of never-smokers was consistent with the main analysis.Likewise, we did not find any association between elevated SDC1 and TM and increase in dyspnea score: SDC1: OR 1.43 (95% CI: 0.89-2.30, = 0.14), TM: OR 1.05 (95% CI: 0.65-1.71, = 0.26).
We did not find a significant association between elevated biomarkers of endothelial injury and decline in lung function nor dyspnea.
内皮损伤可能会促使肺功能下降。我们旨在调查接受良好治疗的HIV感染者（PLWH）中，血栓调节蛋白（TM）和 Syndecan-1（SDC1）水平升高是否与肺功能过度下降和呼吸困难加重有关。
一项对哥本哈根市患者进行的前瞻性队列研究。我们纳入了698名病毒载量检测不到的PLWH。在基线时测量生物标志物和人口统计学指标，在基线和2年随访时进行肺功能测定[一秒用力呼气量（FEV）和用力肺活量（FVC）]以及呼吸困难评分。两种生物标志物均在第三个四分位数处进行二分法划分。使用具有患者特定随机效应的线性混合模型估计肺功能下降情况。使用一般混合逻辑回归模型估计呼吸困难评分的增加情况。
我们未发现SDC1或TM升高与FEV的过度下降之间存在关联：SDC1：4.5毫升/年（95%置信区间：-3.9至12.9，P = 0.30），TM：2.2毫升/年（95%置信区间：-6.0至10.4，P = 0.60）；也未发现与FVC的过度下降存在关联：SDC1：4.1毫升/年（95%置信区间：-6.0至14.2，P = 0.42），TM：1.4毫升/年（95%置信区间：-8.3至11.1，P = 0.78）。从不吸烟者的亚组分析与主要分析结果一致。同样，我们未发现SDC1和TM升高与呼吸困难评分增加之间存在任何关联：SDC1：比值比1.43（95%置信区间：0.89至2.30，P = 0.14），TM：比值比1.05（95%置信区间：0.65至1.71，P = 0.26）。
我们未发现内皮损伤生物标志物升高与肺功能下降或呼吸困难之间存在显著关联。
