THE RELATIONSHIP OF HEPATIC STEATOSIS TO ENDOTHELIAL DYSFUNCTION IN PATIENTS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 在HIV感染者中，NAFLD的存在与血管损伤和心血管疾病的证据增加有关，这是由于全身脂氧合酶的激活，进而导致内皮功能障碍和促进动脉粥样硬化。 具体目标是： 1.明确HIV感染者肝脏脂肪变性对血管内皮损伤严重程度和大血管状态的影响。 2.通过脂质组学分析，探讨HIV患者肝内皮细胞功能障碍与肝脏脂肪变性的关系。 在这项先导性研究中，将从数据库(VCU IRB#6033)中选择10名之前因肝脏疾病接受过肝活检并有脂肪变性(5%)的HIV患者和10名年龄(5岁)、性别和种族匹配的无脂肪变性的HIV患者。所有科目都将符合纳入/排除标准。在基线人口学指标中，患者的主要危险因素包括：合并疾病(糖尿病、高血压、乙肝或丙型肝炎)、抗逆转录病毒治疗史、身体成分(使用人体测量学和DEXA)、代谢综合征的存在(使用ATPIII标准)、饮酒(通过审计进行评估)、THC使用、吸烟史以及CBC、CD4/CD8、HIV RNA和血清化学(基础代谢和肝脏成分)和空腹血脂的实验室。主端点是增加的CIMT。受试者的血管内皮功能障碍将通过手指动脉脉搏波幅度(Entopat)进行评估，并将计算Framingham评分以预测未来的心血管风险。将进行磁共振波谱检查以评估肝脏脂肪变性。将评估血清/血浆的胰岛素抵抗(HOMA-IR)、炎症生物标志物和脂组分析。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In HIV infected subjects, the presence of NAFLD is associated with increased evidence of vascular injury and cardiovascular disease due to the systemic activation of lipoxygenase which in turn causes endothelial dysfunction and promotes atherosclerosis. The specific aims: 1. To define the impact of hepatic steatosis on the severity of endothelial injury and macrovascular cardiovascular status in subjects with HIV infection. 2. To assess, through lipidomic analysis, the relationship between endothelial dysfunction and hepatic steatosis in patients with HIV. In this pilot study, 10 HIV patients who had previously undergone liver biopsy for liver disease who have steatosis (>5%) and 10 matched by age (¿ 5 yrs), gender, and race without steatosis (<5%) will be selected from the data base (VCU IRB#6033). All subjects will meet inclusion/exclusion criteria. At baseline demographics, comorbid conditions (diabetes, hypertension, hepatitis B or C), antiretroviral therapy history, body composition (using anthropometrics and DEXA), presence of the metabolic syndrome (using ATPIII criteria), alcohol use (assessed by AUDIT), THC use, smoking history, and laboratories for CBC, CD4/CD8, HIV RNA, and serum chemistries (basic metabolic and hepatic panel) and fasting lipids. The primary endpoint is increased cIMT. Subjects will have endothelial dysfunction assessed by finger arterial pulse wave amplitude (EndoPAT) and Framingham score will be calculated for future cardiovascular risk. MR spectroscopy will be performed to assess for hepatic steatosis. Serum/plasma will be assessed for insulin resistance (HOMA-IR), inflammatory biomarkers, and lipidomic analysis.