Carotid Intimal Medial Thickness in Human Immunodeficiency Virus-infected Women: Effects of Protease Inhibitor Use, Cardiac Risk Factors, and the Metabolic Syndrome

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2006 Sep 28

PMID 17003092

Citations 43

Authors

Stine Johnsen

Sara E Dolan

Kathleen V Fitch

Jenna R Kanter

Linda C Hemphill

Jean M Connelly

Robert S Lees

Hang Lee

Steve Grinspoon

Affiliations

Soon will be listed here.

Abstract

Context: Little is known regarding carotid intimal medial thickness (IMT) in HIV-infected women and the risk factors for subclinical atherosclerosis in this population, including antiretroviral therapy and the metabolic syndrome.

Objective: Our objective was to assess carotid IMT in relationship to HIV status and antiretroviral therapy in HIV-infected women in comparison with healthy age- and body mass index (BMI)-matched control subjects.

Setting And Subjects: The study took place at an academic medical center and included 97 HIV-infected women compared with 86 age- and BMI-matched healthy control subjects.

Main Outcome Measures: We assessed carotid IMT, metabolic syndrome, and risk factors for increased IMT.

Results: Carotid IMT was not increased in HIV-infected women [0.62 mm (0.57-0.68); median (IQR)] compared with non-HIV-infected women [0.61 mm (0.55-0.68)] matched for age and BMI (P = 0.07) but was increased significantly among HIV patients receiving a protease inhibitor (PI) [0.65 (0.59-0.71) mm] vs. non-PI-treated patients [0.61 (0.57-0.66) mm] (P < 0.05) and vs. control subjects [0.61 (0.55-0.68) mm] (P < 0.05). The prevalence of metabolic syndrome was significantly increased among the HIV-infected women compared with control subjects and particularly in PI- vs. non-PI-treated HIV patients (45 vs. 19%, P = 0.001). Metabolic syndrome score correlated with IMT among non-HIV patients but not among the HIV group. Individual risk factors most strongly associated with IMT in multivariate regression modeling in the control group were age and waist-to-hip ratio, and among the HIV group age and waist circumference.

Conclusions: These data demonstrate increased carotid IMT in HIV-infected women receiving PI therapy, which may be due to associated metabolic abnormalities related to PI therapy or more direct effects of this medication class on the vasculature. Additional studies of the mechanisms by which PI uses results in subclinical atherosclerosis are needed.

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References

Kablak-Ziembicka A, Tracz W, Przewlocki T, Pieniazek P, Sokolowski A, Konieczynska M . Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart. 2004; 90(11):1286-90. PMC: 1768551. DOI: 10.1136/hrt.2003.025080. View

Scuteri A, Najjar S, Muller D, Andres R, Hougaku H, Metter E . Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol. 2004; 43(8):1388-95. DOI: 10.1016/j.jacc.2003.10.061. View

Espeland M, Craven T, RILEY W, Corson J, Romont A, Furberg C . Reliability of longitudinal ultrasonographic measurements of carotid intimal-medial thicknesses. Asymptomatic Carotid Artery Progression Study Research Group. Stroke. 1996; 27(3):480-5. DOI: 10.1161/01.str.27.3.480. View

Chambless L, Heiss G, Folsom A, Rosamond W, Szklo M, Sharrett A . Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol. 1997; 146(6):483-94. DOI: 10.1093/oxfordjournals.aje.a009302. View

Bots M, Hoes A, Koudstaal P, Hofman A, Grobbee D . Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997; 96(5):1432-7. DOI: 10.1161/01.cir.96.5.1432. View

Juonala M, Viikari J, Laitinen T, Marniemi J, Helenius H, Ronnemaa T . Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the cardiovascular risk in young Finns study. Circulation. 2004; 110(18):2918-23. DOI: 10.1161/01.CIR.0000147540.88559.00. View

Jerico C, Knobel H, Montero M, Ordonez-Llanos J, Guelar A, Gimeno J . Metabolic syndrome among HIV-infected patients: prevalence, characteristics, and related factors. Diabetes Care. 2004; 28(1):132-7. DOI: 10.2337/diacare.28.1.132. View

Grinspoon S, Carr A . Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med. 2005; 352(1):48-62. DOI: 10.1056/NEJMra041811. View

Rohani M, Jogestrand T, Ekberg M, van der Linden J, Kallner G, Jussila R . Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease. Atherosclerosis. 2005; 179(2):311-6. DOI: 10.1016/j.atherosclerosis.2004.10.012. View

10.

Dolan S, Hadigan C, Killilea K, Sullivan M, Hemphill L, Lees R . Increased cardiovascular disease risk indices in HIV-infected women. J Acquir Immune Defic Syndr. 2005; 39(1):44-54. DOI: 10.1097/01.qai.0000159323.59250.83. View

11.

Currier J, Kendall M, Zackin R, Henry W, Alston-Smith B, Torriani F . Carotid artery intima-media thickness and HIV infection: traditional risk factors overshadow impact of protease inhibitor exposure. AIDS. 2005; 19(9):927-33. PMC: 1373680. DOI: 10.1097/01.aids.0000171406.53737.f9. View

12.

Iglseder B, Cip P, Malaimare L, Ladurner G, Paulweber B . The metabolic syndrome is a stronger risk factor for early carotid atherosclerosis in women than in men. Stroke. 2005; 36(6):1212-7. DOI: 10.1161/01.STR.0000166196.31227.91. View

13.

Charakida M, Donald A, Green H, Storry C, Clapson M, Caslake M . Early structural and functional changes of the vasculature in HIV-infected children: impact of disease and antiretroviral therapy. Circulation. 2005; 112(1):103-9. DOI: 10.1161/CIRCULATIONAHA.104.517144. View

14.

Johnsen S, Dolan S, Fitch K, Killilea K, Shifren J, Grinspoon S . Absence of polycystic ovary syndrome features in human immunodeficiency virus-infected women despite significant hyperinsulinemia and truncal adiposity. J Clin Endocrinol Metab. 2005; 90(10):5596-604. DOI: 10.1210/jc.2005-1083. View

15.

Shankar S, Dube M, Gorski J, Klaunig J, Steinberg H . Indinavir impairs endothelial function in healthy HIV-negative men. Am Heart J. 2005; 150(5):933. DOI: 10.1016/j.ahj.2005.06.005. View

16.

de Saint Martin L, Vandhuick O, Guillo P, Bellein V, Bressollette L, Roudaut N . Premature atherosclerosis in HIV positive patients and cumulated time of exposure to antiretroviral therapy (SHIVA study). Atherosclerosis. 2005; 185(2):361-7. DOI: 10.1016/j.atherosclerosis.2005.06.049. View

17.

van Wijk J, de Koning E, Cabezas M, Joven J, Roodt J, Rabelink T . Functional and structural markers of atherosclerosis in human immunodeficiency virus-infected patients. J Am Coll Cardiol. 2006; 47(6):1117-23. DOI: 10.1016/j.jacc.2005.09.073. View

18.

Solages A, Vita J, Thornton D, Murray J, Heeren T, Craven D . Endothelial function in HIV-infected persons. Clin Infect Dis. 2006; 42(9):1325-32. PMC: 2737346. DOI: 10.1086/503261. View

19.

Lo J, Dolan S, Kanter J, Hemphill L, Connelly J, Lees R . Effects of obesity, body composition, and adiponectin on carotid intima-media thickness in healthy women. J Clin Endocrinol Metab. 2006; 91(5):1677-82. PMC: 3210448. DOI: 10.1210/jc.2005-2775. View

20.

Dolan S, Kanter J, Grinspoon S . Longitudinal analysis of bone density in human immunodeficiency virus-infected women. J Clin Endocrinol Metab. 2006; 91(8):2938-45. PMC: 3207203. DOI: 10.1210/jc.2006-0127. View