创伤后应激障碍与感染艾滋病毒女性的内皮功能障碍有关。
Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV.
作者信息
Vatsa Nishant, Rahbar Alireza, Kauser Tanveer, Kirksey Ariel, Gold Daniel A, Jain Vardhmaan, Gold Matthew E, Wang Heqiong, Mehta Christina, Moran Caitlin A, Smith Alicia K, Hagen Kimbi, Ofotokun Ighovwerha, Lahiri Cecile D, Sperling Laurence, Vaccarino Viola, Mehta Puja K, Quyyumi Arshed A, Neigh Gretchen N, Michopoulos Vasiliki
机构信息
Division of Cardiology, Emory University, Atlanta, Georgia, USA.
Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA.
出版信息
JACC Adv. 2025 Feb;4(2):101572. doi: 10.1016/j.jacadv.2024.101572. Epub 2025 Jan 19.
BACKGROUND
HIV induced endothelial dysfunction (ED) contributes to cardiovascular disease (CVD) in women with HIV (WWH). Although psychosocial stress has been implicated in the development of CVD in HIV, its impact on ED in WWH remains unknown.
OBJECTIVES
The authors hypothesized that posttraumatic stress disorder (PTSD) and HIV interact to contribute to ED in WWH.
METHODS
We enrolled 87 women from the Women's Interagency HIV Study in Atlanta, Georgia, who reported previous trauma and completed the PTSD Checklist: Civilian Version (PCL-C), which assesses PTSD symptom severity (PCL-C score) and PTSD status (PCL-C >44). Brachial artery flow-mediated dilation (FMD) was measured to assess endothelial function. The impact of PTSD, HIV, and their interaction on endothelial function was evaluated using linear regression models adjusted for demographics, CVD risk factors, depressive symptoms, and statin use.
RESULTS
Overall, 55 (63.2%) had HIV, 24 (27.5%) had PTSD, and 13 (14.9%) had both. Those with PTSD were more likely to smoke (18 [75%] vs 28 [44.4%], P = 0.02) and have depressive symptoms (14 [58.3%] vs 18 [28.6%], P = 0.02) than those without PTSD. In adjusted models, the HIV-PTSD (severity and status) interaction effect on FMD was significant (P = 0.01). Both PTSD severity (β per 10-point increase: -0.72% [95% CI: -1.22 to -0.21], P = 0.01) and PTSD status (β: -2.51% [95% CI: -4.21 to -0.77], P = 0.01) were independently associated with lower FMD in WWH but not in those without HIV.
CONCLUSIONS
PTSD is independently associated with ED in WWH. Whether treatment for PTSD improves ED and CVD in WWH needs further study.
背景
HIV 诱导的血管内皮功能障碍（ED）会导致感染 HIV 的女性（WWH）患心血管疾病（CVD）。尽管心理社会压力与 HIV 感染者患 CVD 有关，但其对 WWH 的 ED 的影响尚不清楚。
目的
作者假设创伤后应激障碍（PTSD）与 HIV 相互作用会导致 WWH 出现 ED。
方法
我们招募了来自佐治亚州亚特兰大市女性机构间 HIV 研究的 87 名女性，她们报告曾有过创伤经历并完成了创伤后应激障碍检查表：平民版（PCL-C），该表用于评估创伤后应激障碍症状的严重程度（PCL-C 评分）和创伤后应激障碍状态（PCL-C>44）。测量肱动脉血流介导的舒张功能（FMD）以评估血管内皮功能。使用针对人口统计学、CVD 危险因素、抑郁症状和他汀类药物使用情况进行调整的线性回归模型，评估 PTSD、HIV 及其相互作用对血管内皮功能的影响。
结果
总体而言，55 名（63.2%）患有 HIV，24 名（27.5%）患有 PTSD，13 名（14.9%）两者都有。与没有 PTSD 的人相比，患有 PTSD 的人更有可能吸烟（18 名[75%]对 28 名[44.4%]，P = 0.02）和有抑郁症状（14 名[58.3%]对 18 名[28.6%]，P = 0.02）。在调整后的模型中，HIV-PTSD（严重程度和状态）对 FMD 的交互作用显著（P = 0.01）。PTSD 严重程度（每增加 10 分的β值：-0.72%[95%CI：-1.22 至-0.21]，P = 0.01）和 PTSD 状态（β值：-2.51%[95%CI：-4.21 至-0.77]，P = 0.01）均与 WWH 中较低的 FMD 独立相关，但在未感染 HIV 的人中则不然。
结论
PTSD 与 WWH 的 ED 独立相关。PTSD 的治疗是否能改善 WWH 的 ED 和 CVD 需要进一步研究。
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