Peripheral arterial disease and ankle-brachial index abnormalites in young and middle-aged HIV-positive patients in lower Silesia, Poland.
Peripheral arterial disease and ankle-brachial index abnormalites in young and middle-aged HIV-positive patients in lower Silesia, Poland.
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DOI：
10.1371/journal.pone.0113857
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Witkiewicz W
中科院分区：
文献类型：
--
作者：
Kwiatkowska W;Knysz B;Arczyńska K;Drelichowska J;Czarnecki M;Gąsiorowski J;Karczewski M;Witkiewicz W
外周动脉疾病（PAD）是动脉粥样硬化的临床表现，主要针对老年患者，对其功能和生活质量产生负面影响。先前针对 HIV 感染者的研究结果表明，与普通人群相比，其心血管风险更高，PAD 发生的频率也更高。也存在相互矛盾的观察。对于无症状 HIV 感染者的踝臂指数 (ABI) 值知之甚少。本研究的目的是评估一组波兰 HIV 阳性患者中 PAD 和踝臂指数异常的患病率，并确定与该疾病相关的危险因素。 111 名年轻至中年 HIV 阳性受试者和 40 名未感染受试者被纳入该研究。进行静息 ABI 测量并分析心血管风险。根据 ABI 值创建亚组：低 (PAD)、临界、正常、高和改变的 ABI。在 2 名 HIV 阳性患者中观察到有症状的 PAD，但未诊断出无症状的 PAD。 ABI 值较低且变化较大，研究组中 22.5% 的人发现 ABI 值发生改变。 6 名受试者表现出临界 ABI，15 名受试者表现出高 ABI，包括 >1.4。在对照组中，没有报告低或非常高的值。低 ABI 与心血管家族史之间以及 ABI 改变与高密度脂蛋白胆固醇 (HDL-C) 水平之间的关系已得到证实。在年轻和中年 HIV 阳性患者中，有症状的 PAD 患病率与总体人群中观察到的患病率相当。无症状患者中没有 PAD 的报道。与 HIV 阴性受试者相比，HIV 阳性患者的 ABI 值变化更大； ABI 的改变与低 HDL-C 水平和代谢综合征密切相关。
Peripheral arterial disease (PAD) is a clinical manifestation of atherosclerosis and mainly refers to elderly patients, having a negative impact on their functionality and quality of life. The findings of previous studies in HIV-infected patients have shown that cardiovascular risk is higher and PAD occurs more frequently than in the general population. There are also contradictory observations. Much less is known about the ankle-brachial index (ABI) value in asymptomatic HIV-infected patients. The aim of this study was to evaluate the prevalence of PAD and ankle-brachial index abnormalities as well as to determine risk factors related to the disease in a group of Polish HIV–positive patients. One hundred and eleven young to middle aged HIV–positive subjects and 40 noninfected subjects were enrolled into the study. Resting ABI measurements were performed and cardiovascular risk was analysed as well. Subgroups were created according to the ABI values: low (PAD), borderline, normal, high and altered ABI. Symptomatic PAD was observed in 2 HIV–positive patients, asymptomatic PAD was not diagnosed. The ABI value is lower and more varied, in 22.5% of the study group altered ABI values were found. Six subjects demonstrated borderline ABI, and 15 high ABI, including >1.4. In the control group no low or very high values were reported. A relation between low ABI and cardiovascular family history and between altered ABI and high–density–lipoprotein cholesterol (HDL–C) level was demonstrated. In young and middle–aged HIV–positive patients, symptomatic PAD prevalence is comparable to that observed in the overall population. Among asymptomatic patients PAD is not reported. The ABI value in HIV–positive patients is more varied compared to the HIV–negative subjects; the altered ABI shows a strong relation with low HDL–C levels and metabolic syndrome.
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DOI：
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