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Association of Lower Adiponectin Plasma Levels, Increased Age and Smoking with Subclinical Atherosclerosis in Patients with HIV-1 Infection

[ Vol. 18 , Issue. 4 ]

Author(s):

Philipe Quagliato Bellinati, Daniela Frizon Alfieri, Tamires Flauzino, Paulo Fernando Gasparetto Junior, Diogo Jorge Rossi, José Wander Breganó, Andrea Name Colado Simão, Elaine Regina Delicato de Almeida, Marcell Alysson Batisti Lozovoy and Edna Maria Vissoci Reiche*   Pages 292 - 306 ( 15 )

Abstract:


Background: The association between subclinical atherosclerosis and traditional cardiovascular disease (CVD) risk factors, inflammatory and metabolic biomarkers has been demonstrated around the world and specifically Brazilian human immunodeficiency virus type 1 (HIV-1)- infected individuals. However, the association between subclinical atherosclerosis and these aforementioned factors combined with anti-inflammatory biomarkers has not been examined in these populations.

Objectives: To evaluate the association of the carotid intima-media thickness (cIMT) with CVD risk factors, inflammatory, metabolic and HIV-1 infection markers combined with adiponectin and interleukin (IL)-10 as anti-inflammatory variables.

Methods: In this case-control study, 49 HIV-1-infected patients on combined antiretroviral therapy (cART) and 85 controls were compared for traditional CVD risk factors, inflammatory, metabolic, and anti-inflammatory variables. Further, we compared HIV-1-infected patients according to their cIMT (as continuous and categorized <0.9 or ≥0.9 mm variable) visualized by carotid ultrasonography doppler (USGD).

Results: Twenty-four (48.9%) HIV-1-infected patients showed cIMT ≥0.9 mm. The patients had higher levels of C reactive protein on high sensitivity assay (hsCRP), tumor necrosis factor α, IL-6, IL-10, triglycerides, and insulin, and lower levels of adiponectin, total cholesterol and low-density lipoprotein cholesterol than controls (all p<0.05). Low levels of adiponectin were negatively associated with cIMT ≥0.9 mm (p=0.019), and explained 18.7% of the cIMT variance. Age (p=0.033) and current smoking (p=0.028) were positively associated with cIMT values, while adiponectin levels (p=0.008) were negatively associated with cIMT values; together, these three variables explained 27.3% of cIMT variance.

Conclusion: Low adiponectin was associated with higher cIMT in HIV-1-infected patients on cART. Low adiponectin levels in combination with age and smoking could explain, in part, the increased subclinical atherosclerosis observed in these patients. Adiponectin may be a good candidate for predicting subclinical atherosclerosis in the management of HIV-1-infected patients in public health care, especially where USGD is not available.

Keywords:

HIV-1, adiponectin, subclinical atherosclerosis, carotid intima-media thickness, inflammation, biomarker.

Affiliation:

Infectious Diseases Unity, University Hospital, Londrina State University, Londrina, Paraná, Department of Pharmaceutical Sciences, Health Sciences Center, Londrina State University, Londrina, Paraná, Laboratory of Research in Applied Immunology, Health Sciences Center, Londrina State University, Londrina, Paraná, Vascular Unity, University Hospital, Londrina State University, Londrina, Paraná, Infectious Diseases Unity, University Hospital, Londrina State University, Londrina, Paraná, Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, Londrina State University, Londrina, Paraná, Laboratory of Research in Applied Immunology, Health Sciences Center, Londrina State University, Londrina, Paraná, Laboratory of Research in Applied Immunology, Health Sciences Center, Londrina State University, Londrina, Paraná, Laboratory of Research in Applied Immunology, Health Sciences Center, Londrina State University, Londrina, Paraná, Laboratory of Research in Applied Immunology, Health Sciences Center, Londrina State University, Londrina, Paraná

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