HIV-1 Infection in Methamphetamine Abusers: Endocrine Outcomes

描述(由申请人提供)：HIV-1感染与内分泌系统的不良后果有关。非法药物滥用是感染艾滋病毒-1的主要风险因素，也与异常的内分泌结果有关。包括我们在内的几项研究报告称，吸毒者HIV-1+的内分泌异常加剧。但这些调查是在可卡因和/或阿片成瘾者中进行的，美国的药物滥用文化正在改变。甲基苯丙胺(冰毒)正在全国各地成为一种首选毒品，在南佛罗里达州，尤其是在男男性接触者中，冰毒滥用急剧上升。然而，关于甲基苯丙胺对艾滋病毒-1感染中内分泌的影响的调查很少。据推测，在滥用HIV-1+冰毒的男男性接触者中，肾上腺活动增加，甲状腺功能亢进，胰岛素抵抗的发生率增加。为了验证这些假设，这项为期5年的申请建议对三组总共450名男性的肾上腺、甲状腺和胰岛素活性进行横断面调查：HIV-1+冰毒滥用者(n=150)，HIV-1冰毒滥用者(n=150)，非HIV-1非冰毒滥用者(n=150)，分布在非裔美国人、高加索人和拉美裔美国人中。由于计划将重点放在男男性接触者身上，这项研究将只包括男性。目的1：研究HIV-1+MSM、HIV-1-MSM和非HIV-1对照受试者的肾上腺活动(ACTH和皮质醇水平)以及对地塞米松-CRH联合激发的反应。目的：了解HIV-1合并男男性接触者、HIV-1男男性接触者和非HIV-1对照人群的甲状腺功能(TSH、T4、T3)和甲状腺抗体水平。目的：探讨吸毒-HIV-1+MSM、吸毒-HIV-1-MSM和非HIV-1对照人群的胰岛素活性。这些内分泌紊乱可能会给滥用冰毒的男男性同性恋者带来一些严重的医疗后果和后果的巨大负担，并进一步允许制定适当的干预措施。 与公共健康相关：甲基苯丙胺(冰毒)滥用，特别是在南佛罗里达州的男男性接触者中，已经飙升。虽然已对HIV-1感染和吸毒者感染HIV-1的内分泌后果进行了调查，但关于滥用HIV-1+冰毒的男男性行为者的内分泌后果的信息很少。这项建议调查了这一人群的肾上腺、甲状腺和胰岛素活动。据认为，不良的内分泌结果可能会导致巨大的医疗负担。

DESCRIPTION (provided by applicant): HIV-1 Infection is associated with adverse outcomes in endocrine systems. Illicit drug abuse is a major risk factor for contracting HIV-1 infection and is also associated with abnormal endocrine outcomes. Several studies including ours have reported exacerbated endocrine abnormalities among drug abusing HIV-1+ individuals. But these investigations have been carried out among cocaine and/or opioids addicts, and the culture of drug abuse in the United States is changing. Methamphetamine (meth) is becoming a drug of choice all over the country and its abuse in South Florida particularly among MSM has skyrocketed. There is, however, a scarcity of investigations on the impact of methamphetamine on endocrines in HIV-1 infection. It is hypothesized that adrenal activity will be increased, there will be a hyper activity of thyroid as well as an increased incidence of insulin resistance, among HIV-1+ meth abusing MSM. In order to test these hypotheses, this 5 year application proposes to investigate cross sectionally adrenal, thyroid, and insulin activity in a total of 450 men in three groups: HIV-1+ meth abusers (n=150), HIV-1- meth abusers (n=150), HIV-1 - non-meth abusers (n=150) distributed among African Americans, Caucasians, and Hispanics. Because of the planned focus on MSM, only men will be included in the study. The following are aims: Aim 1: To investigate adrenal activity (ACTH and cortisol levels) as well as response to the combined dexamethasone-CRH challenge among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants. Aim 2: To investigate thyroid activity (TSH, T4 and T3) as well as thyroid antibodies among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants. Aim 3: To explore insulin activity among meth abusing-HIV-1+ MSM; meth abusing HIV-1- MSM and HIV-1- meth-free control participants. These endocrine disturbances may lead to enormous burden of a number of serious medical consequences and outcomes in meth abusing MSM and further allow developing suitable interventions. PUBLIC HEALTH RELEVANCE: Methamphetamine (meth) abuse particularly among MSM in South Florida has skyrocketed. Although endocrine outcomes in HIV-1 infection as well as drug abusers with HIV- 1 infection have been investigated, there is scarcity of information regarding such outcomes in HIV-1+ meth abusing MSM. This proposal investigates adrenal, thyroid and insulin activities in this population. It is proposed that adverse endocrine outcomes may result in an enormous medical burden.