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英国非洲裔 HIV 感染者的心血管疾病风险。

Cardiovascular disease risk in people of African ancestry with HIV in the United Kingdom.

机构信息

King's College Hospital NHS Foundation Trust, London, UK.

Berkshire Healthcare NHS Foundation Trust, Slough, UK.

出版信息

HIV Med. 2024 Dec;25(12):1289-1297. doi: 10.1111/hiv.13706. Epub 2024 Aug 29.

Abstract

OBJECTIVES

Our objective was to describe the prevalence of cardiovascular disease (CVD) risk factors in people of African ancestry with HIV in the UK.

METHODS

We conducted a cross-sectional analysis of CVD risk factors in Black people with HIV aged ≥40 years and estimated the 10-year CVD risk using QRISK®3-2018. Correlations between body mass index (BMI) and CVD risk factors were described using Pearson correlation coefficients, and factors associated with 10-year CVD risk ≥5% were described using logistic regression.

RESULTS

We included 833 Black people with HIV and a median age of 54 years; 54% were female, 50% were living with obesity (BMI ≥30 kg/m), 61% had hypertension, and 19% had diabetes mellitus. CVD risk >5% ranged from 2% in female participants aged 40-49 years to 99% in men aged ≥60 years, and use of statins ranged from 7% in those with CVD risk <2.5% to 64% in those with CVD risk ≥20%. BMI was correlated (R 0.1-0.2) with triglycerides and diastolic blood pressure in women and with glycated haemoglobin, systolic and diastolic blood pressure, and total:high-density lipoprotein (HDL) cholesterol ratio in men. In both female and male participants, older age, blood pressure, diabetes mellitus, and kidney disease were strongly associated with CVD risk ≥5%, whereas obesity, total:HDL cholesterol, triglycerides, and smoking status were variably associated with CVD risk ≥5%.

CONCLUSIONS

We report a high burden of CVD risk factors, including obesity, hypertension, and diabetes mellitus, in people of African ancestry with HIV in the UK. BMI-focused interventions in these populations may improve CVD risk while also addressing other important health issues.

摘要

目的

本研究旨在描述英国艾滋病毒感染者中非洲裔人群的心血管疾病(CVD)危险因素流行情况。

方法

我们对≥40 岁的非洲裔艾滋病毒感染者进行 CVD 危险因素的横断面分析,并使用 QRISK®3-2018 估算 10 年 CVD 风险。采用 Pearson 相关系数描述体重指数(BMI)与 CVD 危险因素之间的相关性,采用逻辑回归描述与 10 年 CVD 风险≥5%相关的因素。

结果

我们纳入了 833 名年龄在 40 至 89 岁的非洲裔艾滋病毒感染者,其中 54%为女性,50%患有肥胖症(BMI≥30kg/m),61%患有高血压,19%患有糖尿病。CVD 风险>5%的比例从 40-49 岁女性参与者的 2%到≥60 岁男性的 99%不等,他汀类药物的使用率从 CVD 风险<2.5%的参与者的 7%到 CVD 风险≥20%的参与者的 64%不等。在女性参与者中,BMI 与甘油三酯和舒张压呈正相关(R 值为 0.1-0.2),在男性参与者中,BMI 与糖化血红蛋白、收缩压和舒张压以及总胆固醇:高密度脂蛋白(HDL)胆固醇比值呈正相关。在女性和男性参与者中,年龄较大、血压升高、糖尿病和肾脏疾病与 CVD 风险≥5%密切相关,而肥胖、总胆固醇:HDL 胆固醇、甘油三酯和吸烟状况与 CVD 风险≥5%存在差异相关。

结论

本研究报告了英国非洲裔艾滋病毒感染者中 CVD 危险因素负担高,包括肥胖症、高血压和糖尿病。针对这些人群的 BMI 为重点的干预措施可能会改善 CVD 风险,同时也解决其他重要的健康问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b645/11608579/cb4caceafdfe/HIV-25-1289-g001.jpg

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