Soluble CD14 is independently associated with coronary calcification and extent of subclinical vascular disease in treated HIV infection.
Soluble CD14 is independently associated with coronary calcification and extent of subclinical vascular disease in treated HIV infection.
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DOI：
10.1097/qad.0000000000000158
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发表时间：
2014-04-24
期刊：
影响因子：
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通讯作者：
McComsey GA
中科院分区：
文献类型：
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作者：
Longenecker CT;Jiang Y;Orringer CE;Gilkeson RC;Debanne S;Funderburg NT;Lederman MM;Storer N;Labbato DE;McComsey GA
在接受抗逆转录病毒治疗（ART）的HIV感染患者人群中，使用多模态成像来探讨炎症、T细胞活化和单核细胞活化的生物标志物与冠状动脉钙化和亚临床血管疾病的关系。横截面。对147例接受抗逆转录病毒治疗的HIV感染成人（HIV RNA低于1000拷贝/ml，低密度脂蛋白胆固醇（LDL-C）130 mg/dl或更低）进行了一组可溶性和细胞炎症和免疫激活生物标志物的测定，我们研究了生物标志物与冠状动脉钙（CAC）评分和亚临床血管疾病的多种超声测量的关系。总体而言，中位（四分位距，IQR）年龄为46（40-53）岁;四分之三的参与者为男性，三分之二为非洲裔美国人。中位10年Fragrance风险评分为6%。CAC大于0的参与者年龄较大，不太可能是非洲裔美国人，并且具有较高的当前和较低的最低CD 4 + T细胞计数。大多数生物标志物在有和没有CAC的患者之间是相似的;然而，在调整传统的危险因素后，可溶性CD 14与CAC独立相关。在CAC评分为零的患者中，T细胞活化和全身炎症分别与颈动脉内膜中层厚度和肱动脉充血速度相关。与正常对照组和单纯CAC组相比，亚临床血管病变程度加重组sCD 14、hs-CRP和Fg水平升高（均P<0.05）。可溶性CD 14与冠状动脉钙化独立相关，并且在可检测到钙的患者中，可预测其他血管床亚临床疾病的程度。未来的研究应探讨多模态成像的效用，以表征血管疾病的表型在这一人群中。
To use multimodality imaging to explore the relationship of biomarkers of inflammation, T-cell activation and monocyte activation with coronary calcification and subclinical vascular disease in a population of HIV-infected patients on antiretroviral therapy (ART). Cross-sectional. A panel of soluble and cellular biomarkers of inflammation and immune activation was measured in 147 HIV-infected adults on ART with HIV RNA less than 1000 copies/ml and low-density lipoprotein cholesterol (LDL-C) 130 mg/dl or less. We examined the relationship of biomarkers to coronary calcium (CAC) score and multiple ultrasound measures of subclinical vascular disease. Overall, median (interquartile range, IQR) age was 46 (40–53) years; three-quarters of participants were male and two-thirds African-American. Median 10-year Framingham risk score was 6%. Participants with CAC more than 0 were older, less likely to be African-American and had higher current and lower nadir CD4+ T-cell counts. Most biomarkers were similar between those with and without CAC; however, soluble CD14 was independently associated with CAC after adjustment for traditional risk factors. Among those with a CAC score of zero, T-cell activation and systemic inflammation correlated with carotid intima–media thickness and brachial hyperemic velocity, respectively. Compared with normal participants and those with CAC only, participants with increasing degrees of subclinical vascular disease had higher levels of sCD14, hs-CRP and fibrinogen (all P<0.05). Soluble CD14 is independently associated with coronary artery calcification, and, among those with detectable calcium, predicts the extent of subclinical disease in other vascular beds. Future studies should investigate the utility of multimodality imaging to characterize vascular disease phenotypes in this population.