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HIV感染者中TyG指数、肝脏脂肪变性与免疫衰老之间的关联

Association Between TyG Index, Liver Steatosis and Immunosenescence in People Living with HIV.

作者信息

Yan Haiming, Chen Suling, Gao Xinrui, Jiang Yuanhui, Liang Guangyu, Peng Jie, Cai Shaohang

机构信息

Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.

State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education; Guangdong Provincial Key Laboratory of Viral Hepatitis Research; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology, Guangzhou, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Nov 13;17:5049-5059. doi: 10.2147/IDR.S493140. eCollection 2024.

Abstract

BACKGROUND

Metabolic disorders and immunosenescence increase the risk of complications in people living with HIV (PLWH), affecting mortality and quality of life. However, their relationship remains unclear.

METHODS

Participants were grouped by median TyG index, and logistic regression identified baseline independent factors of a high TyG index at Week 24. The association of the TyG index for hepatic steatosis was determined using ROC curves. We also explored correlations between the TyG index and aging markers, including CD4/CD8 ratio and CD8+ T cells and evaluated health-related quality of life (HRQoL).

RESULTS

A total of 203 PLWH were included in the study. We observed that PLWH in high TyG group tended to be older (P<0.001), have greater body weight (P<0.001), higher ALT levels (P=0.021), and increased low-density lipoprotein levels (P=0.001). ROC analysis revealed that TyG index was closely associated with hepatic steatosis at Week 52 (AUC=0.743) and Week 104 (AUC=0.728). Moreover, a higher TyG index was positively correlated with CD8+ T cell counts, while patients in the high TyG group had lower CD4/CD8 ratios at Week 52 and Week 104. Poorer mental health was observed in patients with CD8+ T cell counts ≥1000 and a high TyG index. Multivariate analysis further identified baseline older age (OR=1.108, P=0.002), elevated cholesterol (OR=3.407, P<0.001), and low HDL (OR=0.003, P<0.001) as factors associated with a high TyG index at Week 24.

CONCLUSION

The TyG index is closely linked to metabolic disorders and immunosenescence in PLWH. It offers a basis for personalized treatment strategies, improving physical and mental health and reducing complication risks.

摘要

背景

代谢紊乱和免疫衰老会增加人类免疫缺陷病毒感染者(PLWH)发生并发症的风险,影响死亡率和生活质量。然而,它们之间的关系仍不清楚。

方法

根据TyG指数中位数对参与者进行分组,并通过逻辑回归确定第24周时高TyG指数的基线独立因素。使用ROC曲线确定TyG指数与肝脂肪变性的关联。我们还探讨了TyG指数与衰老标志物(包括CD4/CD8比值和CD8 + T细胞)之间的相关性,并评估了健康相关生活质量(HRQoL)。

结果

本研究共纳入203名PLWH。我们观察到,高TyG组的PLWH往往年龄较大(P<0.001)、体重更大(P<0.001)、ALT水平更高(P = 0.021)且低密度脂蛋白水平升高(P = 0.001)。ROC分析显示,TyG指数与第52周(AUC = 0.743)和第104周(AUC = 0.728)的肝脂肪变性密切相关。此外,较高的TyG指数与CD8 + T细胞计数呈正相关,而高TyG组的患者在第52周和第104周时CD4/CD8比值较低。在CD8 + T细胞计数≥1000且TyG指数高的患者中观察到较差的心理健康状况。多变量分析进一步确定基线年龄较大(OR = 1.108,P = 0.002)、胆固醇升高(OR = 3.407,P<0.001)和HDL低(OR = 0.003,P<0.001)是与第24周时高TyG指数相关的因素。

结论

TyG指数与PLWH的代谢紊乱和免疫衰老密切相关。它为个性化治疗策略提供了依据,可改善身心健康并降低并发症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9861/11570526/fe3b2ac5b2b3/IDR-17-5049-g0001.jpg

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