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Bourgeois BL, Levitt DE, Molina PE, Simon L. Differential expression of adipocyte and myotube extracellular vesicle miRNA cargo in chronic binge alcohol-administered SIV-infected male macaques. Alcohol 2023; 108:1-9. [PMID: 36351490 PMCID: PMC10033305 DOI: 10.1016/j.alcohol.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
Abstract
Our studies in chronic binge alcohol (CBA) -treated simian immunodeficiency virus (SIV)-infected macaques and in people living with HIV (PLWH) show significant alterations in metabolic homeostasis. CBA promotes a profibrotic phenotype in adipose tissue and skeletal muscle (SKM) and decreases adipose-derived stem cell and myoblast differentiation, making adipose and SKM potential drivers in metabolic dysregulation. Furthermore, we have shown that the differential expression of microRNAs (miRs) in SKM contributes to impaired myoblast differentiation potential. Beyond modulation of intracellular responses, miRs can be transported in extracellular vesicles (EVs) to mediate numerous cellular responses through intercellular and interorgan communication. This study tested the hypothesis that CBA alters concentration and miR cargo of EVs derived from adipocytes and myotubes isolated from SIV-infected male macaques. Fourteen male rhesus macaques received either CBA (2.5 g/kg/day) or sucrose (VEH) for 14.5 months. Three months following the initiation of CBA/VEH, all animals were infected with SIVmac251 and 2.5 months later were initiated on antiretroviral therapy. SKM and adipose tissue samples were collected at the study endpoint (blood alcohol concentration = 0 mM). EVs were isolated by ultracentrifugation of myotube and adipocyte cell culture supernatant. Nanoparticle tracking revealed no differences in concentration or size of particles between VEH and CBA groups. Adipocyte-derived EVs from CBA animals showed decreased miR-let-7a expression (p = 0.03). Myotube-derived EVs from CBA animals had decreased miR-16 (p = 0.04) and increased miR-133a and miR-133b (both p = 0.04) expression. These results indicate that CBA administration differentially regulates EV miR content but does not alter the number of EVs from adipocytes or myotubes. Future studies are warranted to determine the functional relevance of CBA-altered EV miR cargo and their role in intercellular and interorgan communication and metabolic dysregulation.
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Affiliation(s)
- Brianna L Bourgeois
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Danielle E Levitt
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Patricia E Molina
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Liz Simon
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
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2
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Navarro J, Curran A, Raventós B, García J, Suanzes P, Descalzo V, Álvarez P, Espinosa N, Montes ML, Suárez-García I, Amador C, Muga R, Falcó V, Burgos J. Prevalence of non-alcoholic fatty liver disease in a multicentre cohort of people living with HIV in Spain. Eur J Intern Med 2023; 110:54-61. [PMID: 36764905 DOI: 10.1016/j.ejim.2023.01.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is one of the most important liver comorbidities in people living with HIV (PLWH). Factors that could lead to a higher prevalence of NAFLD or ease the onset of fibrosis are unclear. METHODS Cohort study of the Spanish HIV Research Network, which comprehends 46 hospitals and more than 15,000 PLWH. Primary objectives were to assess NAFLD prevalence and liver fibrosis according to hepatic steatosis index (HSI) and NAFLD fibrosis score, respectively. Factors associated with both were analysed. RESULTS A total of 4798 PLWH were included of whom 1461 (30.5%) showed an HSI>36; these patients had higher risk for significant fibrosis (OR 1.91; 95%CI 1.11-3.28). Factors associated with NAFLD were body mass index (OR 2.05; 95%CI 1.94-2.16) and diabetes (OR 4.68; 95%CI 2.17-10.08), while exposure to integrase strand transfer inhibitors showed a lower risk (OR 0.78; 95%CI 0.62-0.97). In patients with HSI>36, being female (OR 7.33; 95%CI 1.34-40), age (OR 1.22; 95%CI 1.11-1.34), body mass index (OR 1.35; 95%CI 1.18-1.54) and exposure to thymidine analogues (OR 75.4, 95%CI 6.9-823.5) were associated with a higher risk of significant fibrosis. However, exposure to non-nucleoside reverse transcriptase inhibitors (OR 0.12, 95%CI 0.02-0.89) and time of exposure to protease inhibitors (OR 0.97, 95%CI 0.95-1) showed a lower risk. CONCLUSION NAFLD prevalence was high in our cohort. Patients exposed to INSTI showed a lower risk of NAFLD. In patients with hepatic steatosis, exposure to thymidine analogues had 75-fold more risk of significant fibrosis while exposure to NNRTIs reduced this risk.
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Affiliation(s)
- Jordi Navarro
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain.
| | - Adrian Curran
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain.
| | - Berta Raventós
- Institut de Recerca Vall d'Hebron, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jorge García
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Paula Suanzes
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Vicente Descalzo
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Patricia Álvarez
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Nuria Espinosa
- Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Marisa Luisa Montes
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - Inés Suárez-García
- Infectious Diseases Group, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Concha Amador
- Unidad de Enfermedades Infecciosas, Hospital de la Marina Baixa, Alicante, Spain
| | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol - IGTP, Badalona, Spain
| | - Vicenç Falcó
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - Joaquín Burgos
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron, Barcelona, Spain
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Kaser S, Hofer SE, Kazemi-Shirazi L, Festa A, Winhofer Y, Sourij H, Brath H, Riedl M, Resl M, Clodi M, Stulnig T, Ress C, Luger A. [Other specific types of diabetes and exocrine pancreatic insufficiency (update 2023)]. Wien Klin Wochenschr 2023; 135:18-31. [PMID: 37101022 PMCID: PMC10133035 DOI: 10.1007/s00508-022-02123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 04/28/2023]
Abstract
The heterogenous category "specific types of diabetes due to other causes" encompasses disturbances in glucose metabolism due to other endocrine disorders such as acromegaly or hypercortisolism, drug-induced diabetes (e.g. antipsychotic medications, glucocorticoids, immunosuppressive agents, highly active antiretroviral therapy (HAART), checkpoint inhibitors), genetic forms of diabetes (e.g. Maturity Onset Diabetes of the Young (MODY), neonatal diabetes, Down‑, Klinefelter- and Turner Syndrome), pancreatogenic diabetes (e.g. postoperatively, pancreatitis, pancreatic cancer, haemochromatosis, cystic fibrosis), and some rare autoimmune or infectious forms of diabetes. Diagnosis of specific diabetes types might influence therapeutic considerations. Exocrine pancreatic insufficiency is not only found in patients with pancreatogenic diabetes but is also frequently seen in type 1 and long-standing type 2 diabetes.
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Affiliation(s)
- Susanne Kaser
- Universitätsklinik für Innere Medizin 1, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - Sabine E Hofer
- Universitätsklinik für Pädiatrie 1, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Lili Kazemi-Shirazi
- Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Andreas Festa
- Abteilung für Innere Medizin I, LK Stockerau, Stockerau, Österreich
| | - Yvonne Winhofer
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Harald Sourij
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Helmut Brath
- Mein Gesundheitszentrum Favoriten, Österreichische Gesundheitskasse, Wien, Österreich
| | - Michaela Riedl
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Michael Resl
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich
| | - Martin Clodi
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich
- ICMR - Institute for Cardiovascular and Metabolic Research, JKU Linz, Linz, Österreich
| | - Thomas Stulnig
- 3. Medizinische Abteilung und Karl Landsteiner Institut für Stoffwechselerkrankungen und Nephrologie, Klinik Hietzing, Wien, Österreich
| | - Claudia Ress
- Universitätsklinik für Innere Medizin 1, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - Anton Luger
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
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Kiyimba T, Kigozi F, Yiga P, Mukasa B, Ogwok P, Van der Schueren B, Matthys C. The cardiometabolic profile and related dietary intake of Ugandans living with HIV and AIDS. Front Nutr 2022; 9:976744. [PMID: 36034927 PMCID: PMC9403861 DOI: 10.3389/fnut.2022.976744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Suboptimal diet and physical inactivity downgrade the putative benefits of Antiretroviral Therapy (ART) among People Living with HIV (PLWH). However, there is paucity of literature on dietary intake and cardiometabolic profiles of PLWH in Uganda. Methods A cross-sectional study among PLWH in Uganda was conducted. Dietary intake was assessed using a 24h recall method of 2 non-consecutive days. The short International Physical Activity Questionnaire assessed participants' physical activity. Fasted blood samples were analyzed for Fasting Blood Glucose (FBG), total cholesterol, LDL-c, HDL-c and triglycerides. Blood pressure and anthropometric measurements were performed following step 2 of the WHO STEPS. Results 253 patients completed in this study. A high prevalence of low HDL-c (31.9%), abdominal obesity (44.5%), high BMI (51.6%), raised FBG (45.3%), high SBP (31.5%), elevated triglycerides (26.4%) and metabolic syndrome (28%) was found. More women were identified with metabolic syndrome (31.5%) than men (19.2%). Low prevalence of high LDL-c (4.7%) and total cholesterol (9.8%) was found. Diets had a high carbohydrate (65.8 ± 10.4) E% and fiber intake (30.1 ± 12.7) g with minimal PUFA (6.1 ± 2.3) E%, fruits and vegetables (1.4 servings). High proportions were found of unmet intake for vitamin A (38.2%), B1(48.8%), B2 (29.6%), B12 (29%), folate (61.4%), Ca (76%), Zn (53.1%) and Mg (41.7%). Mean MET min was 6,700 ± 5,509 and over 68% of the participants had >3,000 MET min. Conclusion Our findings reveal a high prevalence of metabolic disturbances among PLWH in Uganda and further highlight that their diets are suboptimal with low fruits and vegetable intake
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Affiliation(s)
- Tonny Kiyimba
- Department of Food Technology, Faculty of Science, Kyambogo University, Kampala, Uganda.,Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Fred Kigozi
- Nutrition Unit, Department of Health Sciences, School of Applied Sciences, Mildmay Institute of Health Sciences, Kampala, Uganda
| | - Peter Yiga
- Department of Food Technology, Faculty of Science, Kyambogo University, Kampala, Uganda.,Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | | | - Patrick Ogwok
- Department of Food Technology, Faculty of Science, Kyambogo University, Kampala, Uganda
| | - Bart Van der Schueren
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.,Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.,Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
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5
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Bourgeois BL, Lin HY, Yeh AY, Levitt DE, Primeaux SD, Ferguson TF, Molina PE, Simon L. Unique circulating microRNA associations with dysglycemia in people living with HIV and alcohol use. Physiol Genomics 2022; 54:36-44. [PMID: 34859690 PMCID: PMC8891241 DOI: 10.1152/physiolgenomics.00085.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
People living with HIV (PLWH) have increased prevalence of comorbid conditions including insulin resistance and at-risk alcohol use. Circulating microRNAs (miRs) may serve as minimally invasive indicators of pathophysiological states. We aimed to identify whether alcohol modulates circulating miR associations with measures of glucose/insulin dynamics in PLWH. PLWH (n = 96; 69.8% males) enrolled in the Alcohol & Metabolic Comorbidities in PLWH: Evidence-Driven Interventions (ALIVE-Ex) study were stratified into negative phosphatidylethanol (PEth < 8 ng/mL, n = 42) and positive PEth (PEth ≥ 8 ng/mL, n = 54) groups. An oral glucose tolerance test (OGTT) was administered, and total RNA was isolated from fasting plasma to determine absolute miR expression. Circulating miRs were selected based on their role in skeletal muscle (miR-133a and miR-206), pancreatic β-cell (miR-375), liver (miR-20a), and adipose tissue (miR-let-7b, miR-146a, and miR-221) function. Correlation and multiple regression analyses between miR expression and adiponectin, 2 h glucose, insulin, and C-peptide values were performed adjusting for body mass index (BMI) category, age, sex, and viral load. miR-133a was negatively associated with adiponectin (P = 0.002) in the negative PEth group, and miR-20a was positively associated with 2 h glucose (P = 0.013) in the positive PEth group. Regression analyses combining miRs demonstrated that miR-133a (P < 0.001) and miR-221 (P = 0.010) together predicted adiponectin in the negative PEth group. miR-20a (P < 0.001) and miR-375 (P = 0.002) together predicted 2 h glucose in the positive PEth group. Our results indicate that associations between miRs and measures of glucose/insulin dynamics differed between PEth groups, suggesting that the pathophysiological mechanisms contributing to altered glucose homeostasis in PLWH are potentially modulated by alcohol use.
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Affiliation(s)
- Brianna L. Bourgeois
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Hui-Yi Lin
- 2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana,3School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Alice Y. Yeh
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Danielle E. Levitt
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Stefany D. Primeaux
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,4Joint Diabetes, Endocrinology & Metabolism Program, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Tekeda F. Ferguson
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana,5Department of Epidemiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Patricia E. Molina
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Liz Simon
- 1Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana,2Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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New-Aaron M, Ganesan M, Dagur RS, Kharbanda KK, Poluektova LY, Osna NA. Pancreatogenic Diabetes: Triggering Effects of Alcohol and HIV. BIOLOGY 2021; 10:108. [PMID: 33546230 PMCID: PMC7913335 DOI: 10.3390/biology10020108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023]
Abstract
Multiorgan failure may not be completely resolved among people living with HIV despite HAART use. Although the chances of organ dysfunction may be relatively low, alcohol may potentiate HIV-induced toxic effects in the organs of alcohol-abusing, HIV-infected individuals. The pancreas is one of the most implicated organs, which is manifested as diabetes mellitus or pancreatic cancer. Both alcohol and HIV may trigger pancreatitis, but the combined effects have not been explored. The aim of this review is to explore the literature for understanding the mechanisms of HIV and alcohol-induced pancreatotoxicity. We found that while premature alcohol-inducing zymogen activation is a known trigger of alcoholic pancreatitis, HIV entry through C-C chemokine receptor type 5(CCR5)into pancreatic acinar cells may also contribute to pancreatitis in people living with HIV (PLWH). HIV proteins induce oxidative and ER stresses, causing necrosis. Furthermore, infiltrative immune cells induce necrosis on HIV-containing acinar cells. When necrotic products interact with pancreatic stellate cells, they become activated, leading to the release of both inflammatory and profibrotic cytokines and resulting in pancreatitis. Effective therapeutic strategies should block CCR5 and ameliorate alcohol's effects on acinar cells.
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Affiliation(s)
- Moses New-Aaron
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Veteran Affairs Nebraska—Western Iowa Health Care System, Omaha, NE 68105, USA; (M.G.); (R.S.D.); (K.K.K.)
| | - Murali Ganesan
- Veteran Affairs Nebraska—Western Iowa Health Care System, Omaha, NE 68105, USA; (M.G.); (R.S.D.); (K.K.K.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Raghubendra Singh Dagur
- Veteran Affairs Nebraska—Western Iowa Health Care System, Omaha, NE 68105, USA; (M.G.); (R.S.D.); (K.K.K.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kusum K. Kharbanda
- Veteran Affairs Nebraska—Western Iowa Health Care System, Omaha, NE 68105, USA; (M.G.); (R.S.D.); (K.K.K.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Larisa Y. Poluektova
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Natalia A. Osna
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Veteran Affairs Nebraska—Western Iowa Health Care System, Omaha, NE 68105, USA; (M.G.); (R.S.D.); (K.K.K.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA;
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Simon L, Ferguson TF, Vande Stouwe C, Brashear MM, Primeaux SD, Theall KP, Welsh DA, Molina PE. Prevalence of Insulin Resistance in Adults Living with HIV: Implications of Alcohol Use. AIDS Res Hum Retroviruses 2020; 36:742-752. [PMID: 32449647 DOI: 10.1089/aid.2020.0029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Unhealthy alcohol use is prevalent among persons living with HIV (PLWH). Aging and increased survival of PLWH on antiretroviral therapy (ART) are complicated by metabolic dysregulation and increased risk of insulin resistance (IR) and diabetes mellitus. The objective of this study was to determine the prevalence and association of IR with unhealthy alcohol use in adult in-care PLWH. A cross-sectional analysis of metabolic parameters and alcohol use characteristics was conducted in adult PLWH enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. IR was estimated using homeostatic model assessment (HOMA-IR), triglyceride index, and McAuley index and beta cell function (HOMA-β). Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT)-C, 30-day timeline followback (TLFB), lifetime drinking history, and phosphatidylethanol (PEth) measures. A total of 351 participants, with a mean age [±standard deviation (SD)] of 48.1 ± 10.4 years, were included (69.6% male). Of these, 57% had an AUDIT-C score of 4 or greater, indicating unhealthy alcohol use. Mean body mass index (BMI) was 27.2 ± 7.0 kg/m2, 36.4% met criteria for metabolic syndrome, and 14% were diagnosed with diabetes. After adjusting for education, race, BMI, smoking status, viral load, CD4 count, use of protease inhibitors, statins, or metformin; physical activity and diabetes diagnosis, HOMA-IR, and McAuley index were negatively associated with AUDIT-C, and HOMA-β cell function was negatively associated with AUDIT-C, PEth, and TLFB. Cross-sectional analysis of NOAH participants indicates that alcohol use is associated with decreased HOMA-β cell function, suggesting dysregulation of endocrine pancreatic function.
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Affiliation(s)
- Liz Simon
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Tekeda F. Ferguson
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Curtis Vande Stouwe
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Meghan M. Brashear
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Stefany D. Primeaux
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Katherine P. Theall
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - David A. Welsh
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Pulmonary/Critical Care and Allergy/Immunology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Patricia E. Molina
- Louisiana State University Health Sciences Center, Comprehensive Alcohol-HIV/AIDS Research Center, New Orleans, Louisiana, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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8
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Iacovelli A, Mezzaroma I, Di Paolo M, Soda G, De Vincentiis L, Palange P. A case of acanthosis nigricans in a HIV-infected patient. BMC Infect Dis 2020; 20:360. [PMID: 32434484 PMCID: PMC7238735 DOI: 10.1186/s12879-020-05089-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background To date, very little information is available concerning the relationship between acanthosis nigricans (AN) and infection with human immunodeficiency virus type 1 (HIV-1). Case presentation Herein, we report the case of a middle-aged man admitted for fever and progressively worsening dyspnea in the context of an opportunistic pneumonia and firstly diagnosed with acquired immunodeficiency syndrome (AIDS). At the time of diagnosis, physical examination revealed the presence of a palpable, hyperpigmented skin lesion on the left areola with surface desquamation and velvety texture consistent with AN. Of note, the most common primary etiologies related to AN were excluded and the complete regression of the skin lesion was observed once antiretroviral therapy was started. Conclusion This is the second report of AN found in patients with AIDS and apparently responsive to prolonged antiretroviral treatment. Possible explanations of this association are still not completely understood, probably related to virus-induced changes in lipid metabolism. Our experience suggests that HIV testing should always be considered in the setting of apparently idiopathic AN.
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Affiliation(s)
- Alessandra Iacovelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Marcello Di Paolo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Soda
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | | | - Paolo Palange
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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9
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[Other specific types of diabetes and exocrine pancreatic insufficiency (Update 2019)]. Wien Klin Wochenschr 2019; 131:16-26. [PMID: 30980164 DOI: 10.1007/s00508-019-1454-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The heterogenous catagory "specific types of diabetes due to other causes" encompasses disturbances in glucose metabolism due to other endocrine disorders such as acromegaly or hypercortisolism, drug-induced diabetes (e. g. antipsychotic medications, glucocorticoids, immunosuppressive agents, highly active antiretroviral therapy (HAART)), genetic forms of diabetes (e. g. Maturity Onset Diabetes of the Young (MODY), neonatal diabetes, Down Syndrome, Klinefelter Syndrome, Turner Syndrome), pancreatogenic diabetes (e. g. postoperatively, pancreatitis, pancreatic cancer, haemochromatosis, cystic fibrosis), and some rare autoimmune or infectious forms of diabetes. Diagnosis of specific diabetes types might influence therapeutic considerations. Exocrine pancreatic insufficiency is not only found in patients with pancreatogenic diabetes but is also frequently seen in type 1 and long-standing type 2 diabetes.
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Factors Associated With Insulin Resistance in Adults With HIV Receiving Contemporary Antiretroviral Therapy: a Brief Update. Curr HIV/AIDS Rep 2019; 15:223-232. [PMID: 29700760 DOI: 10.1007/s11904-018-0399-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW This narrative review summarizes recent data on factors associated with insulin resistance (IR) in adults with HIV, including contemporary antiretroviral therapy (ART). RECENT FINDINGS IR remains common in persons with HIV, even those receiving contemporary ART. Generalized and abdominal obesity and ectopic fat are correlates of IR, and emerging data have identified associations with biomarkers of inflammation and immune activation. Small studies suggest associations between mitochondria and IR. In ART-naïve individuals, IR increased within 4 weeks of starting ART in persons receiving contemporary boosted protease inhibitors or an integrase inhibitor. The importance of IR in non-diabetic persons with HIV will continue to grow as the population ages and obesity increases. Non-invasive estimates of IR appear to perform well in persons with HIV, but clinically relevant cutoffs are uncertain. Unexpected metabolic effects of newer HIV integrase inhibitors have been reported; thus, careful observation for and studies of IR are still warranted.
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Melo ES, Costa CRB, Foresto JS, Antonini M, Pontes PS, Reis RK. Análisis de la dislipidemia en adultos que viven con VIH. REVISTA CUIDARTE 2019. [DOI: 10.15649/cuidarte.v10i2.776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introducción: En el contexto de las personas que viven con VIH (PVVIH), la dislipidemia es un tema que se ha venido discutiendo ampliamente, tanto por su origen multifactorial y sus implicaciones cardiovasculares, como por las posibles estrategias de prevención. De este modo, este estudio tiene por objeto evaluar la presencia de la dislipidemia en personas que viven con VIH y su asociación con aspectos sociodemográficos, actitudinales y clínicos. Materiales y Métodos: Estudio analítico, transversal realizado entre 2014 y 2016. Los datos fueron recolectados a través de entrevistas en las que se utilizaban cuestionarios y se consultaban las historias médicas. Para analizar la asociación, se utilizaron las pruebas Chi-Cuadrado y Exacto de Fisher, y la estadística Kappa para análisis de concordancia, con un nivel de significancia de p<0,05. Resultados: Participaron 340 personas en el estudio, de las cuales 59,1%, presentaron valores deseables en términos de colesterol total, 55,9% del HDL y 56,8% de triglicéridos. Las variables asociadas a la dislipidemia fueron: el colesterol total alterado y la edad a partir de 40 años (p=0,02); el HDL-c deseable y el sexo femenino (p=0,007); alteración de los triglicéridos y el tiempo de diagnóstico mayor a diez años (p=0,008); y el HDL-c deseable y la carga viral indetectable (p=0,04). Discusión: Aunque la dislipidemia sea un problema en el contexto del VIH, los valores deseables fueron más prevalentes, lo que se refleja sobre el efecto catalizador de la actividad inflamatoria causada por el VIH sobre las alteraciones lipídicas. Conclusiones: La dislipidemia en las PVVIH presentó, en su gran mayoría, valores deseables para el colesterol total, colesterol HDL y triglicéridos; y hubo una asociación entre los lípidos y los aspectos sociodemográficos y clínicos relacionados con el VIH.
Como citar este artigo: Melo ES, Costa CRB, Foresto JS, Antonini M, Pontes PS, Reis RK. Análise da dislipidemia em adultos vivendo com HIV. Rev Cuid. 2019; 10(2): e776. http://dx.doi.org/10.15649/cuidarte.v10i2.776
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Tadesse BT, Foster BA, Chala A, Chaka TE, Bizuayehu T, Ayalew F, H/Meskel G, Tadesse S, Jerene D, Makonnen E, Aklillu E. HIV and cART-Associated Dyslipidemia Among HIV-Infected Children. J Clin Med 2019; 8:jcm8040430. [PMID: 30925831 PMCID: PMC6518233 DOI: 10.3390/jcm8040430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/15/2019] [Accepted: 03/26/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Persistent dyslipidemia in children is associated with risks of cardiovascular accidents and poor combination antiretroviral therapy (cART) outcome. We report on the first evaluation of prevalence and associations with dyslipidemia due to HIV and cART among HIV-infected Ethiopian children. METHODS 105 cART naïve and 215 treatment experienced HIV-infected children were enrolled from nine HIV centers. Demographic and clinical data, lipid profile, cART type, adherence to and duration on cART were recorded. Total, low density (LDLc) and high density (HDLc) cholesterol values >200 mg/dL, >130 mg/dL, <40 mg/dL, respectively; and/or, triglyceride values >150 mg/dL defined cases of dyslipidemia. Prevalence and predictors of dyslipidemia were compared between the two groups. RESULTS prevalence of dyslipidemia was significantly higher among cART experienced (70.2%) than treatment naïve (58.1%) children (p = 0.03). Prevalence of low HDLc (40.2% versus 23.4%, p = 0.006) and hypertriglyceridemia (47.2% versus 35.8%, p = 0.02) was higher among cART experienced than naïve children. There was no difference in total hypercholesterolemia and high LDLc levels. Nutrition state was associated with dyslipidemia among cART naïve children (p = 0.01). CONCLUSION high prevalence of cART-associated dyslipidemia, particularly low HDLc and hypertriglyceridemia was observed among treatment experienced HIV-infected children. The findings underscore the need for regular follow up of children on cART for lipid abnormalities.
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Affiliation(s)
- Birkneh Tilahun Tadesse
- Department of Pediatrics, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Byron Alexander Foster
- Departments of Dermatology and Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Adugna Chala
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | | | - Temesgen Bizuayehu
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Freshwork Ayalew
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Getahun H/Meskel
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Sintayehu Tadesse
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | - Degu Jerene
- Management Sciences for Health, Addis Ababa, 1250, Ethiopia.
| | - Eyasu Makonnen
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
- CDT Africa, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
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Arrive E, Viard JP, Salanave B, Dollfus C, Matheron S, Reliquet V, Arezes E, Nailler L, Vigouroux C, Warszawski J. Metabolic risk factors in young adults infected with HIV since childhood compared with the general population. PLoS One 2018; 13:e0206745. [PMID: 30408056 PMCID: PMC6226109 DOI: 10.1371/journal.pone.0206745] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 10/18/2018] [Indexed: 02/05/2023] Open
Abstract
AIM Metabolic risk factors are poorly documented for the first generation of young adults who have lived with HIV since childhood. We compared their metabolic profile with that of adults of same age from the general population. METHODS We conducted a cross-sectional analysis of data from two populations: (1) COVERTE (ANRS-CO19), a French national cohort of 18 to 30-year-old patients HIV-infected since childhood, and (2) ENNS, a national cross-sectional population-based household survey on nutrition. Body mass index (BMI), blood pressure, waist circumference, fasting glucose, triglycerides, and HDL-, LDL- and total cholesterol were measured in both studies. Direct standardization on overweight and education level and logistic regression were used to compare the prevalence of metabolic abnormalities between the two populations. RESULTS Data from 268 patients from COVERTE and 245 subjects from ENNS were analyzed. Tobacco use was similar in both groups. HIV-infected patients had increased mean waist-to-hip ratio and triglycerides to HDL-cholesterol ratio and decreased mean HDL-cholesterol as compared to their counterparts from the general population in both genders. In HIV-infected patients, metabolic syndrome was identified in 13.2% of men (95% confidence interval [CI]: 7.1-19.2) and 10.4% (95% CI: 5.4-15.3) of women versus 10.6% (95%CI: 1.5-19.7) and 1.7% (95%CI: 0-4.1) in subjects from the general population, respectively. CONCLUSION Young adults infected with HIV since childhood had a higher prevalence of dyslipidemia and metabolically detrimental fat distribution than adults of same age of the general population, supporting close monitoring for cardiometabolic diseases.
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Affiliation(s)
- Elise Arrive
- Inserm, Center for Research in Epidemiology and Population Health, Paris, France
- Unité de Formation et de Recherche d’Odontologie, Université de Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, France
- * E-mail: (EA); (CV)
| | - Jean-Paul Viard
- Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- Unité de Recherche EA 7327, Faculté de Médecine Paris Descartes, Paris, France
| | - Benoît Salanave
- Equipe de Surveillance et d’Epidémiologie Nutritionnelle (ESEN), Santé publique France, Université Paris-13, Centre de recherche en épidémiologie et statistiques COMUE Sorbonne Paris Cité, Bobigny, France
| | - Catherine Dollfus
- Pediatric Hemato-Oncology,Hopital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sophie Matheron
- Hopital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
- Unité Mixte de Recherche 1137, INSERM, Université Paris 7, Paris, France
| | - Véronique Reliquet
- Department of Infectious Diseases and CIC UIC 1413 INSERM, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Elisa Arezes
- Inserm, Center for Research in Epidemiology and Population Health, Paris, France
| | - Laura Nailler
- Inserm, Center for Research in Epidemiology and Population Health, Paris, France
| | - Corinne Vigouroux
- Sorbonne Université, Inserm Unité Mixte de RechercheS 938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Biology and Molecular Genetics and Endocrinology Departments, National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Paris, France
- * E-mail: (EA); (CV)
| | - Josiane Warszawski
- Inserm, Center for Research in Epidemiology and Population Health, Paris, France
- Université Paris-Sud, Le Kremlin-Bicêtre, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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van Zoest RA, van der Valk M, Wit FW, Vaartjes I, Kooij KW, Hovius JW, Prins M, Reiss P. Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy. Eur J Prev Cardiol 2017; 24:1297-1307. [PMID: 28578613 PMCID: PMC5548068 DOI: 10.1177/2047487317714350] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/18/2017] [Indexed: 01/12/2023]
Abstract
Background We aimed to identify the prevalence of cardiovascular risk factors, and investigate preventive cardiovascular medication use and achievement of targets as per Dutch cardiovascular risk management guidelines among human immunodeficiency virus (HIV)-positive and HIV-negative individuals. Design The design was a cross-sectional analysis within an ongoing cohort study. Methods Data on medication use and cardiovascular disease prevalence were available for 528 HIV-positive and 521 HIV-negative participants. We identified cardiovascular risk factors and applied cardiovascular risk management guidelines, mainly focusing on individuals eligible for (a) primary prevention because of high a priori cardiovascular risk, or for (b) secondary prevention. Results One hundred and three (20%) HIV-positive and 77 (15%) HIV-negative participants were classified as having high cardiovascular risk; 53 (10%) HIV-positive and 27 (5%) HIV-negative participants were eligible for secondary prevention. Of HIV-positive individuals 57% at high cardiovascular risk and 42% of HIV-positive individuals eligible for secondary prevention had systolic blood pressures above guideline-recommended thresholds. Cholesterol levels were above guideline-recommended thresholds in 81% of HIV-positive individuals at high cardiovascular risk and 57% of HIV-positive individuals eligible for secondary prevention. No statistically significant differences were observed between HIV-positive and HIV-negative participants regarding achievement of targets, except for glycaemic control (glycated haemoglobin ≤ 53 mmol/mol) among individuals using diabetes medication (90% vs 50%, p = 0.017) and antiplatelet/anticoagulant use for secondary prevention (85% vs 63%, p = 0.045), which were both superior among HIV-positive participants. Conclusions Cardiovascular risk management is suboptimal in both HIV-positive and HIV-negative individuals and should be improved.
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Affiliation(s)
- Rosan A van Zoest
- Department of Global Health, Academic Medical Center, The Netherlands
- Amsterdam Institute for Global Health and Development, The Netherlands
| | - Marc van der Valk
- Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
| | - Ferdinand W Wit
- Department of Global Health, Academic Medical Center, The Netherlands
- Amsterdam Institute for Global Health and Development, The Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
- HIV Monitoring Foundation, The Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Katherine W Kooij
- Department of Global Health, Academic Medical Center, The Netherlands
- Amsterdam Institute for Global Health and Development, The Netherlands
| | - Joppe W Hovius
- Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
| | - Maria Prins
- Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Peter Reiss
- Department of Global Health, Academic Medical Center, The Netherlands
- Amsterdam Institute for Global Health and Development, The Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
- HIV Monitoring Foundation, The Netherlands
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Yeoh HL, Cheng AC, Cherry CL, Weir JM, Meikle PJ, Hoy JF, Crowe SM, Palmer CS. Immunometabolic and Lipidomic Markers Associated With the Frailty Index and Quality of Life in Aging HIV+ Men on Antiretroviral Therapy. EBioMedicine 2017; 22:112-121. [PMID: 28754302 PMCID: PMC5552224 DOI: 10.1016/j.ebiom.2017.07.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 01/09/2023] Open
Abstract
Chronic immune activation persists despite antiretroviral therapy (ART) in HIV+ individuals and underpins an increased risk of age-related co-morbidities. We assessed the Frailty Index in older HIV+ Australian men on ART. Immunometabolic markers on monocytes and T cells were analyzed using flow cytometry, plasma innate immune activation markers by ELISA, and lipidomic profiling by mass spectrometry. The study population consisted of 80 HIV+ men with a median age of 59 (IQR, 56-65), and most had an undetectable viral load (92%). 24% were frail, and 76% were non-frail. Frailty was associated with elevated Glucose transporter-1 (Glut1) expression on the total monocytes (p=0.04), increased plasma levels of innate immune activation marker sCD163 (OR, 4.8; CI 1.4-15.9, p=0.01), phosphatidylethanolamine PE(36:3) (OR, 5.1; CI 1.7-15.5, p=0.004) and triacylglycerol TG(16:1_18:1_18:1) (OR, 3.4; CI 1.3-9.2, p=0.02), but decreased expression of GM3 ganglioside, GM3(d18:1/18:0) (OR, 0.1; CI 0.0-0.6, p=0.01) and monohexosylceramide HexCerd(d18:1/22:0) (OR, 0.1; CI 0.0-0.5, p=0.004). There is a strong inverse correlation between quality of life and the concentration of PE(36:3) (ρ=-0.33, p=0.004) and PE(36:4) (ρ=-0.37, p=0.001). These data suggest that frailty is associated with increased innate immune activation and abnormal lipidomic profile. These markers should be investigated in larger, longitudinal studies to determine their potential as biomarkers for frailty.
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Affiliation(s)
- Hui-Ling Yeoh
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia
| | - Allen C Cheng
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Level 6, The Alfred Centre (Alfred Hospital), 99 Commercial Road, Melbourne, VIC 3004, Australia
| | - Catherine L Cherry
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; School of Physiology, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, 2000 Johannesburg, South Africa
| | - Jacquelyn M Weir
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Peter J Meikle
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Jennifer F Hoy
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia
| | - Suzanne M Crowe
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia
| | - Clovis S Palmer
- Department of Infectious Diseases, The Alfred and Monash University, Level 2, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Department of Microbiology and Immunology, University of Melbourne, Melbourne, Australia.
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16
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Wirunsawanya K, Belyea L, Shikuma C, Watanabe RM, Kohorn L, Shiramizu B, Mitchell BI, Souza SA, Keating SM, Norris PJ, Ndhlovu LC, Chow D. Plasminogen Activator Inhibitor-1 Predicts Negative Alterations in Whole-Body Insulin Sensitivity in Chronic HIV Infection. AIDS Res Hum Retroviruses 2017; 33:723-727. [PMID: 28322572 DOI: 10.1089/aid.2016.0292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Plasminogen activator inhibitor type 1 (PAI-1), a key negative regulator of fibrinolysis, has been investigated to be one of the potential mechanisms of the development of impaired insulin sensitivity, insulin resistance, and diabetes mellitus. Because chronically stable HIV-infected individuals frequently develop abnormal glucose metabolism, including insulin resistance and diabetes mellitus, we postulated that PAI-1 could be one of the multifactorial pathogenic roles in the development of impaired insulin sensitivity and insulin resistance among chronic HIV-infected individuals. From our longitudinal cohort study, we selectively recruited chronically stable HIV-infected individuals without diagnosis of diabetes mellitus at baseline (N = 62) to analyze the correlation of baseline inflammatory cytokines, including PAI-1 and whole-body insulin sensitivity, with 2-year follow-up, as measured by Matsuda Index. We found a negative correlation between baseline PAI-1 and Matsuda Index (r = -0.435, p = .001) and a negative correlation between baseline PAI-1 and Matsuda Index at 2 years (r = -0.377, p = .005). In a linear regression model that included age, total body fat mass percentage, serum amyloid A, and family history of diabetes mellitus, PAI-1 still remained significantly associated with Matsuda Index at 2-year follow-up (β = -.397, p = .002). Our longitudinal study suggests that PAI-1 is an independent predictor of impaired insulin sensitivity among chronic HIV-infected individuals.
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Affiliation(s)
- Kamonkiat Wirunsawanya
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Loni Belyea
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Cecilia Shikuma
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Richard M. Watanabe
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, California
| | - Lindsay Kohorn
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Bruce Shiramizu
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Brooks I. Mitchell
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Scott A. Souza
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
- Queen's Medical Center, Honolulu, Hawaii
| | | | - Philip J. Norris
- Blood Systems Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California, San Francisco, California
- Department of Medicine, University of California, San Francisco, California
| | - Lishomwa C. Ndhlovu
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
- Department of Tropical Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | - Dominic Chow
- Department of Medicine, Hawaii Center for AIDS, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
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Willig AL, Overton ET. Metabolic Complications and Glucose Metabolism in HIV Infection: A Review of the Evidence. Curr HIV/AIDS Rep 2016; 13:289-96. [PMID: 27541600 PMCID: PMC5425100 DOI: 10.1007/s11904-016-0330-z] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
HIV infection and antiretroviral therapy (ART) use are associated with perturbations in glucose and lipid metabolism. Increasing incidence of diabetes, cardiovascular disease, and obesity highlights the need for early identification and treatment of metabolic dysfunction. Newer ART regimens are less toxic for cellular function and metabolism but have failed to completely eliminate metabolic dysfunction with HIV infection. Additional factors, including viral-host interactions, diet, physical activity, non-ART medications, and aging may further contribute to metabolic disease risk in the HIV setting. We summarize the recent literature regarding the impact on metabolic function of HIV infection, ART, and pharmaceutical or lifestyle prescriptions.
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Affiliation(s)
- Amanda L Willig
- Division of Infectious Diseases. UAB Center for AIDS Research, University of Alabama School of Medicine, 845 19th Street South, BBRB 207, Birmingham, AL, 35294, USA
| | - Edgar Turner Overton
- Division of Infectious Diseases, University of Alabama School of Medicine, 908 20th St, South, CCB Rm 330A, Birmingham, AL, 35294, USA.
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