Metabolic syndrome and subclinical atherosclerosis in patients infected with HIV
Metabolic syndrome and subclinical atherosclerosis in patients infected with HIV
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DOI：
10.1086/516616
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发表时间：
2007-05-15
影响因子：
11.8
通讯作者：
Wanke, Christine A.
中科院分区：
文献类型：
--
作者：
Mangili, Alexandra;Jacobson, Denise L.;Wanke, Christine A.
背景资料。本研究检验了人类免疫缺陷病毒(HIV)感染的成年人中颈动脉和冠状动脉粥样硬化以及代谢综合征之间的关系。我们用B型超声测量了314名HIV感染者的颈总动脉和颈内动脉内中膜厚度(c-IMT)，并用高分辨率同步计算机断层扫描测量了冠状动脉钙化(CAC)。代谢综合征由国家胆固醇教育计划/成人治疗小组III标准定义。我们用连续变量的Wilcoxon检验和分类变量的x2检验比较了代谢综合征患者和非代谢综合征患者的c-IMT测量和CAC评分。为了检验代用标记物和代谢综合征之间的关系，我们使用了Logistic回归分析。有代谢综合征的参与者比没有代谢综合征的参与者更有可能有共同的c-IMT测量>；0.8 mm(17%比7%；)，但两组P=。009的内部c-IMT尺寸为11.0 mm(20%比13%；)。CAC评分为阳性的患者更有可能是PP。代谢综合征患者发生15例(80.3%比46.7%)。在调整了性别、年龄、种族和吸烟状况的多变量模型中，有代谢综合征的参与者比没有代谢综合征的参与者更有可能有异常的普通c-IMT测量(优势比[OR]，2.9；PP)和可检测的CAC评分(OR，4.9；)，但内部c-IMT测量没有更高的内部c-IMT测量(OR，1.6；.020P=.0001)。P=。255例结论。我们的研究表明，患有代谢综合征的HIV感染者可能会增加亚临床动脉粥样硬化的风险，并支持在有心血管疾病风险的HIV感染者中筛查代谢综合征。
Background. The present study examines the association between carotid and coronary atherosclerosis and metabolic syndrome in human immunodeficiency virus (HIV)-infected adults.Methods. We measured the common and internal carotid intima-media thickness (c-IMT) using B-mode ultrasonography, and we measured coronary artery calcium (CAC) using high-resolution, electrocardiographic, synchronized, computed tomography, for 314 HIV-infected men and women. Metabolic syndrome was defined by National Cholesterol Education Program/Adult Treatment Panel III criteria. We compared the c-IMT measurements and CAC scores of patients with metabolic syndrome with the scores of those without metabolic syndrome using a Wilcoxon test for continuous variables and a x 2 test for categorical variables. To examine the association between surrogate markers and metabolic syndrome, we used logistic regression analysis.Results. Participants with metabolic syndrome were more likely to have a common c-IMT measurement > 0.8 mm than were those without metabolic syndrome (17% vs. 7%;), but both groups were equally likely to P =. 009 have an internal c-IMT measurement 11.0 mm (20% vs. 13%;). Any positive CAC score was more likely Pp. 15 to occur for participants with metabolic syndrome (80.3% vs. 46.7%;). In a multivariate model adjusted P < .0001 for sex, age, ethnicity, and smoking status, participants with metabolic syndrome were more likely than those without metabolic syndrome to have an abnormal common c-IMT measurement (odds ratio [OR], 2.9; Pp) and detectable CAC scores (OR, 4.9;) but not a higher internal c-IMT measurement (OR, 1.6;.020 P =.0001). P=. 255Conclusion. Our study demonstrates that HIV-infected individuals with metabolic syndrome may be at increased risk for subclinical atherosclerosis and supports screening for metabolic syndrome among HIV-infected patients at risk for cardiovascular disease.