Biomarkers and neurodevelopment in perinatally HIV-infected or exposed youth: a structural equation model analysis.
Biomarkers and neurodevelopment in perinatally HIV-infected or exposed youth: a structural equation model analysis.
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DOI：
10.1097/qad.0000000000000072
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发表时间：
2014-01-28
期刊：
影响因子：
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通讯作者：
Pediatric HIV/AIDS Cohort Study Team
中科院分区：
文献类型：
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作者：
Kapetanovic S;Griner R;Zeldow B;Nichols S;Leister E;Gelbard HA;Miller TL;Hazra R;Mendez AJ;Malee K;Kammerer B;Williams PL;Pediatric HIV/AIDS Cohort Study Team
探讨围产期HIV感染(PHIV+)和围产期HIV暴露但未感染(PHEU)青少年血管功能障碍标志物与神经发育结局的关系。以美国为基础的15个地点的前瞻性队列研究中的横断面设计。在342名青年(212名PHIV+，130名PHEU)中，根据9个选定的血管生物标记物评估了神经发育结果。测定血清脂联素、C反应蛋白(CRP)、纤维蛋白原、白介素6(IL-6)、可溶性血管细胞黏附分子-1(sVCAM-1)、E-选择素(sE-选择素)、单核细胞趋化蛋白(SMCP-1)、细胞间黏附分子-1(sICAM-1)和P-选择素(sP-选择素)水平。入学时使用韦氏儿童智力量表第四版(WISC-IV)，得到一个完整的智商分数和四个指数分数。进行因子分析，将生物标志物减少到与生物学作用相关的因子。结构方程模型(SEM)被用来衡量结果因素和WISC-IV分数之间的关联。参与者的平均年龄为11.4岁，其中54%为女性，70%为黑人。9个生物标志物被聚为三个因子组：F1(纤维蛋白原、CRP和IL-6)；F2(sICAM-1和sVCAM-1)；F3(MCP-1、sP-选择素和sE-选择素)。脂联素与任何因素均无相关性。在总体队列中，SEMS显示F1与WISC-IV处理速度得分显著负相关。在对艾滋病毒状况和其他潜在混杂因素进行调整后，这一影响仍然显著。当仅限于未经调整和经调整的SEM中的PHIV+参与者时，也观察到了类似的关联。纤维蛋白原、C反应蛋白和IL-6的综合测量可以作为潜在的生物标志物，与PHIV+和PHEU年轻人的处理速度相对较慢有关。
To examine the relationship between markers of vascular dysfunction and neurodevelopmental outcomes in perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHEU) youth. Cross-sectional design within a prospective, 15-site US-based cohort study. Neurodevelopmental outcomes were evaluated in relation to nine selected vascular biomarkers in 342 youth (212 PHIV+, 130 PHEU). Serum levels were assessed for adiponectin, C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), soluble vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin), monocyte chemoattractant protein (sMCP-1), intercellular adhesion molecule-1 (sICAM-1), and P-selectin (sP-selectin). The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was administered at entry, yielding a Full-Scale IQ score, and four index scores. Factor analysis was conducted to reduce the biomarkers to fewer factors with related biological roles. Structural equation models (SEMs) were used to measure associations between resulting factors and WISC-IV scores. Mean participant age was 11.4 years, 54% were female, 70% black. The nine biomarkers were clustered into three factor groups: F1 (fibrinogen, CRP, and IL-6); F2 (sICAM-1 and sVCAM-1); and F3 (MCP-1, sP-selectin, and sE-selectin). Adiponectin showed little correlation with any factor. SEMs revealed significant negative association of F1 with WISC-IV processing speed score in the total cohort. This effect remained significant after adjusting for HIV status and other potential confounders. A similar association was observed when restricted to PHIV+ participants in both unadjusted and adjusted SEMs. Aggregate measures of fibrinogen, CRP, and IL-6 may serve as a latent biomarker associated with relatively decreased processing speed in both PHIV+ and PHEU youth.