Epicardial fat is associated with duration of antiretroviral therapy and coronary atherosclerosis

被引：35

作者：

Brener, Michael ^{[1
]}

Ketlogetswe, Kerunne ^{[1
]}

Budoff, Matthew ^{[2
]}

Jacobson, Lisa P. ^{[3
]}

Li, Xiuhong ^{[3
]}

Rezaeian, Panteha ^{[2
]}

Razipour, Aryabod ^{[2
]}

Palella, Frank J., Jr. ^{[4
]}

Kingsley, Lawrence ^{[5
]}

Witt, Mallory D. ^{[2
]}

George, Richard T. ^{[1
]}

Post, Wendy S. ^{[1
,3
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Baltimore, MD USA

[2] Harbor UCLA Med Ctr, Los Angeles Biomed Res Inst, Torrance, CA 90509 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA

[4] Northwestern Univ, Chicago, IL 60611 USA

[5] Univ Pittsburgh, Pittsburgh, PA USA

来源：

AIDS | 2014年 / 28卷 / 11期

基金：

美国国家卫生研究院;

关键词：

antiretroviral therapy; HIV; imaging; plaque; risk factors; HIV-INFECTED MEN; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; HUMAN-IMMUNODEFICIENCY-VIRUS; MULTICENTER AIDS COHORT; ADIPOSE-TISSUE; ARTERY CALCIUM; MYOCARDIAL-INFARCTION; CARDIOVASCULAR RISK; METABOLIC SYNDROME; PROGNOSTIC VALUE;

D O I：

10.1097/QAD.0000000000000116

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

071005 [微生物学]; 100108 [医学免疫学];

摘要：

Objective: Cytokines released by epicardial fat are implicated in the pathogenesis of atherosclerosis. HIV infection and antiretroviral therapy have been associated with changes in body fat distribution and coronary artery disease. We sought to determine whether HIV infection is associated with greater epicardial fat and whether epicardial fat is associated with subclinical coronary atherosclerosis. Design: We studied 579 HIV-infected and 353 HIV-uninfected men aged 40-70 years with noncontrast computed tomography to measure epicardial adipose tissue (EAT) volume and coronary artery calcium (CAC). Total plaque score (TPS) and plaque subtypes (noncalcified, calcified, and mixed) were measured by coronary computed tomography angiography in 706 men. Methods: We evaluated the association between EAT and HIV serostatus, and the association of EAT with subclinical atherosclerosis, adjusting for age, race, and serostatus and with additional cardiovascular risk factors and tested for modifying effects of HIV serostatus. Results: HIV-infected men had greater EAT than HIV-uninfected men (P = 0.001). EAT was positively associated with duration of antiretroviral therapy (P = 0.02), specifically azidothymidine (P < 0.05). EAT was associated with presence of any coronary artery plaque (P = 0.006) and noncalcified plaque (P = 0.001), adjusting for age, race, serostatus, and cardiovascular risk factors. Among men with CAC, EAT was associated with CAC extent (P = 0.006). HIV serostatus did not modify associations between EAT and either CAC extent or presence of plaque. Conclusion: Greater epicardial fat volume in HIV-infected men and its association with coronary plaque and antiretroviral therapy duration suggest potential mechanisms that might lead to increased risk for cardiovascular disease in HIV. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

引用

页码：1635 / 1644

页数：10

共 36 条

[1]

QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].