Insulin resistance and intestinal integrity in children with and without HIV infection in Uganda
Insulin resistance and intestinal integrity in children with and without HIV infection in Uganda
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DOI：
10.1111/hiv.12808
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发表时间：
2019-10-23
期刊：
影响因子：
3
通讯作者：
McComsey, G. A.
中科院分区：
文献类型：
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作者：
Dirajlal-Fargo, S.;Shan, L.;McComsey, G. A.
目的围产期获得性HIV感染（PHIV）儿童和围产期HIV暴露但未感染儿童（HEU）的心脏代谢并发症风险及其与全身炎症和肠道完整性标志物的关系尚未得到很好的确定。在目前的研究中，我们评估了PHIV与HEU和HIV未暴露未感染儿童的胰岛素抵抗，并探讨了与肠道损伤生物标志物的潜在关联。方法这是一项横断面研究，在PHIV，HEU和HIV未暴露，未感染的儿童（HUU），年龄2-10岁，在乌干达登记。PHIV正在接受稳定的抗逆转录病毒治疗（ART），HIV病毒载量< 400 HIV-1 RNA拷贝/mL。采用胰岛素抵抗的稳态模型评估（HOMA-IR）估计胰岛素抵抗。我们测量了全身炎症、单核细胞活化和肠道完整性的标志物。Kruskal-Wallis检验用于比较HIV状态的标志物; Pearson相关性和多元线性回归用于评估HOMA-IR指数与肠道损伤和易位生物标志物的相关性。总体而言，172名参与者参加了这项研究（57名PHIV，59名HEU和56名HUU）。中位年龄为7.8 [四分位距（IQR）6.39，8.84]岁，55%为女性，中位体重指数（BMI）为15（IQR 14.3，15.8）kg/m2。在PHIV中，中位CD4%为37%，93%有病毒载量
Objectives The risk of cardiometabolic complications in children with perinatally acquired HIV infection (PHIVs) and in perinatally HIV-exposed but uninfected children (HEUs) and its relationship to systemic inflammation and markers of gut integrity are not well established. In this current study, we assed insulin resitance in PHIV compared to HEUs and HIV unexposed uninfected children and explored potential association with intestinal damage biomarkers. Methods This was a cross-sectional study in PHIVs, HEUs and HIV-unexposed, uninfected children (HUUs) aged 2-10 years enrolled in Uganda. PHIVs were on stable antiretroviral therapy (ART) with HIV viral load < 400 HIV-1 RNA copies/mL. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). We measured markers of systemic inflammation, monocyte activation and gut integrity. Kruskal-Wallis tests were used to compare markers by HIV status; Pearson correlation and multiple linear regressions were used to assess associations of the HOMA-IR index with biomarkers of intestinal damage and translocation. Results Overall, 172 participants were enrolled in the study (57 PHIVs, 59 HEUs and 56 HUUs). The median age was 7.8 [interquartile range (IQR) 6.39, 8.84] years, 55% were female and the median body mass index (BMI) was 15 (IQR 14.3, 15.8) kg/m(2). Among PHIVs, the median CD4% was 37%, and 93% had viral load