Shor-Posner Gail, Basit Abdul, Lu Ying, Cabrejos Claudio, Chang Jeani, Fletcher Maryann, Mantero-Atienza Emilio, Baum Marianna K
From the Department of Epidemiology and Public Health University of Miami School of Medicine, Miami, Florida USA; From the Deparment of Epidemiology and the Center for the Biopsychosocial Study of AIDSUniversity of Miami School of Medicine, Miami, Florida USA.
From the Department of Epidemiology and Public Health University of Miami School of Medicine, Miami, Florida USA.
Am J Med. 1993 May;94(5):515-519. doi: 10.1016/0002-9343(93)90087-6.
Patients with the acquired immunodeficiency syndrome exhibit marked disturbances in lipid metabolism. Because altered lipid metabolism may affect immune processes, this study characterized the lipid profile of asymptomatic individuals infected with the human immunodeficiency virus (HIV-1), in relationship to immune function.
Serum levels of triglycerides and cholesterol were determined in 94 asymptomatic HIV-1-infected (Centers for Disease Control stage II, III) homosexual men and 42 healthy seronegative control subjects. Immune assessment included measurements of lymphocyte subpopulations (CD4), immune activation (beta 2-microglobulin), natural killer cell function, and lymphocyte proliferation in response to mitogens phytohemagglutinin and pokeweed. Dietary intake was determined using a semiquantitative food frequency questionnaire.
Despite greater consumption of saturated fat and cholesterol, significantly lower levels of total, high-density, and low-density lipoprotein cholesterol were observed in HIV-1-seropositive men, relative to seronegative controls (p < 0.05), with 40% of the HIV-1-infected group demonstrating hypocholesterolemia (less than 150 mg/dL). Low values of total, high-density, and low-density cholesterol were associated with elevated levels of beta 2-microglobulin in HIV-1-seropositive men. No difference between the groups was noted for serum triglycerides. HIV-1-infected subjects did not demonstrate the significant inverse relationship between cholesterol and mitogen response observed in seronegative controls.
These findings indicate that low levels of cholesterol are prevalent during the early stages of HIV-1 infection and associated with specific alterations in immune function, suggesting that hypocholesterolemia may be a useful marker of disease progression.
获得性免疫缺陷综合征患者表现出明显的脂质代谢紊乱。由于脂质代谢改变可能影响免疫过程，本研究对无症状的人类免疫缺陷病毒（HIV-1）感染者的血脂情况及其与免疫功能的关系进行了特征分析。
测定了94名无症状的HIV-1感染（疾病控制中心II期、III期）同性恋男性和42名健康血清学阴性对照者的血清甘油三酯和胆固醇水平。免疫评估包括淋巴细胞亚群（CD4）测量、免疫激活（β2-微球蛋白）、自然杀伤细胞功能以及对丝裂原植物血凝素和商陆的淋巴细胞增殖反应。通过半定量食物频率问卷确定饮食摄入量。
尽管HIV-1血清阳性男性摄入了更多的饱和脂肪和胆固醇，但与血清学阴性对照者相比，他们的总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平显著更低（p < 0.05），40%的HIV-1感染组表现出低胆固醇血症（低于150 mg/dL）。HIV-1血清阳性男性的总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇低值与β2-微球蛋白水平升高有关。两组间血清甘油三酯无差异。HIV-1感染受试者未表现出血清学阴性对照者中观察到的胆固醇与丝裂原反应之间的显著负相关。
这些发现表明，低胆固醇水平在HIV-1感染早期普遍存在，并与免疫功能的特定改变相关，提示低胆固醇血症可能是疾病进展的一个有用标志物。
