Hypertension in HIV-Infected Adults Compared with Similar but Uninfected Adults in China: Body Mass Index-Dependent Effects of Nadir CD4 Count.
Hypertension in HIV-Infected Adults Compared with Similar but Uninfected Adults in China: Body Mass Index-Dependent Effects of Nadir CD4 Count.
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DOI：
10.1089/aid.2017.0008
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发表时间：
2017-05
影响因子：
1.5
通讯作者：
Yingying Ding;Haijiang Lin;Xing Liu;Yucheng Zhang;Frank Y Wong;Yan V Sun;Vincent C Marconi;N. He
中科院分区：
文献类型：
--
作者：
Yingying Ding;Haijiang Lin;Xing Liu;Yucheng Zhang;Frank Y Wong;Yan V Sun;Vincent C Marconi;N. He
高血压是艾滋病毒感染者中一个日益严重的问题。在HIV感染人群中，低最低CD 4计数与高血压之间的关系已有报道。然而，由于不同的体重指数（BMI），最低CD 4对高血压的影响尚未完全阐明。在这项横断面研究中，招募了345名年龄≥40岁的HIV感染者。他们的频率匹配，并与年龄，性别和教育与艾滋病毒未感染的成年人（n = 345）进行比较。HIV感染者的高血压患病率低于HIV未感染者（23.8% vs. 31.9%; p = 0.011），但在调整潜在混杂因素后，这种相关性并不显著。在HIV感染者中，年龄较大、超重、有心血管疾病家族史、最低CD 4计数<50个细胞/μl与高血压独立相关。对BMI分类的个体进行分层发现，CD 4计数最低值--无论是作为一个二分变量（<50个细胞/μl）还是连续变量--在体重不足和肥胖的个体中与高血压相关，但在体重正常和超重的个体中与高血压无关。在未感染艾滋病毒的个体中，年龄较大和腰围高于临界值与高血压显著相关。这是第一个研究表明，CD 4最低值和高血压的关联是在体重不足和肥胖的艾滋病毒感染患者中观察到的。虽然这些结果表明，最低CD 4计数和高血压之间的关系可能是由体重介导的，未来的纵向研究将需要验证的结果，包括其因果通路。
Hypertension is a growing problem in the HIV population. The relationship between low nadir CD4 count and hypertension in the HIV-infected population has been reported. However, the effect of nadir CD4 on hypertension due to a different body mass index (BMI) is yet to be fully elucidated. In this cross-sectional study, 345 HIV-infected participants aged ≥40 years were recruited. They were frequency matched and compared with age, sex, and education with HIV-uninfected adults (n = 345). Hypertension prevalence was lower in HIV-infected than in HIV-uninfected participants (23.8% vs. 31.9%; p = .011), but this association was not significant after adjusting for potential confounders. Among HIV-infected individuals, older age, overweight, with a family history of cardiovascular diseases, and nadir CD4 count <50 cells/μl were independently associated with hypertension. Stratifying individuals with BMI category revealed that nadir CD4 count-regardless if it was operationalized as a dichotomous variable (<50 cells/μl) or continuous variable-was found to be associated with hypertension among individuals who were underweight and obese, but not among those who were normal weight and overweight. Among HIV-uninfected individuals, older age and having a waist circumference above cutoff were significantly associated with hypertension. This is one of the first studies to demonstrate that the association of nadir CD4 and hypertension is observed in underweight and obese HIV-infected patients. While these results suggest that the relationship between nadir CD4 count and hypertension might be mediated by body weight, future longitudinal studies will be needed to validate the findings, including its causal pathways.