A4: PROJ 2: AUTONOMIC FUNCTN IN HIV INFEC W/ ABDOMINAL ADIPOSITY RECEIVING HAART

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。高活性抗逆转录病毒治疗（HAART）的广泛应用与血压升高、糖脂代谢异常、胰岛素抵抗和腹部肥胖增加相一致。这些症状以人类免疫缺陷病毒（HIV）相关脂肪营养不良综合征为特征，是心血管疾病的独立危险因素。我们假设HAART和HIV感染通过干扰自主神经系统诱导HIV相关的脂肪营养不良综合征。心血管自主功能测试（CAFT）是一种使用心电图和连续血压监测来评估自主功能的非侵入性工具。我们项目的目标是；(1)与HIV阴性对照相比，在接受HAART治疗的HIV感染者中，使用CAFT来表征自主神经系统活动，并确定CAFT与计算机断层扫描（CT）和双能x线吸收仪（DEXA）扫描确定脂肪积累之间的相关性；(2)确定平均自主神经偏差评分与CD4计数、胰岛素抵抗和空腹甘油三酯之间的关联。使用cat测定hiv感染者自主神经功能差异的意义在于，它将有助于理解和潜在治疗hiv相关代谢异常和hiv相关脂肪营养不良综合征。对66名参与者进行了心血管测试：28名HIV血清阴性对照，20名HIV阳性非脂肪营养不良（Non-LD）受试者和18名脂肪营养不良（LD）受试者。在调整内脏脂肪后，时域分析显示LD受试者的心率变异性比其他组降低（p0.05）。频域分析显示，与两组相比，休息时LD组高频功率降低，低高频功率比升高，倾斜时LD组与非LD组比较，差异有统计学意义（p 0.05）。

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. The widespread use of highly active antiretroviral therapy (HAART) has coincided with abnormalities of increased blood pressure, impaired glucose and lipid metabolism, insulin resistance, and increased abdominal adiposity. The constellations of these symptoms are characterized in human immunodeficiency virus- (HIV)-associated lipodystrophy syndrome and are independent risk factors for cardiovascular disease. We hypothesize that HAART and HIV infection induce HIV-associated lipodystrophy syndrome through a disturbance of the autonomic nervous system. Cardiovascular autonomic function testing (CAFT) is a non-invasive tool using an electrocardiogram and continuous blood pressure monitoring that can assess autonomic function. The objectives of our project are; (1) To characterize autonomic nervous system activity using CAFT in HIV-infected individuals receiving HAART compared to HIV negative controls, and to determine the correlation between CAFT with respect to the computerized tomography (CT) and dual-energy x-ray absorptiometry (DEXA) scans determined adipose accumulation, and (2) To determine the association between the mean autonomic deviation score and CD4 count, insulin resistance and fasting triglyceride. The significance of using CAFT in determining autonomic function differences in HIV-infected individuals is that it will aid in the understanding and potential treatment of HIV-associated metabolic abnormalities and HIV-associated lipodystrophy syndrome. Cardiovagal testing was performed on 66 participants: 28 HIV sero-negative controls, 20 HIV positive non-lipodystrophic (Non-LD) subjects, and 18 lipodystrophic (LD) subjects. After adjustment for visceral fat, time domain analysis showed decreased heart rate variability in subjects with LD compared to the other groups (p0.05). The frequency domain analysis showed decreased high frequency power and increased low-to-high frequency power ratio in the LD group compared to both groups during rest, and to Non-LD during tilt (p 0.05).