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Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term

Kristin E Mondy1, Lisa de las Fuentes, Alan Waggoner

  • 1Washington University School of Medicine, St Louis, MO, USA.

AIDS (London, England)
|April 23, 2008
PubMed

Insights

Cardiovascular disease markers were similar between HIV-infected and HIV-negative individuals. However, insulin resistance emerged as a key predictor of endothelial dysfunction and increased carotid intima-media thickness in the HIV cohort.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Biology

Background:

  • Cardiovascular disease (CVD) risk is elevated in individuals with HIV, potentially due to multifactorial causes.
  • Noninvasive vascular tests may yield varied results, necessitating comprehensive assessment of CVD predictors.

Purpose of the Study:

  • To evaluate metabolic and clinical predictors of endothelial function and carotid intima-media thickness in HIV-infected individuals.
  • To compare these markers between HIV-infected subjects on stable antiretroviral therapy and HIV-negative controls.

Main Methods:

  • Prospective, cross-sectional study matching 50 HIV-infected adults to 50 HIV-negative controls.
  • Assessed flow-mediated vasodilation, carotid intima-media thickness, body composition, and metabolic markers (insulin, lipids, glucose tolerance).

Main Results:

  • No significant differences in flow-mediated vasodilation or carotid intima-media thickness between HIV-infected and control groups.
  • In HIV-infected subjects, insulin resistance predicted endothelial dysfunction and increased carotid intima-media thickness.
  • Hypertension and body fat distribution also predicted increased carotid intima-media thickness.

Conclusions:

  • Preclinical CVD markers were comparable between HIV-infected individuals on modern therapy and controls.
  • Insulin resistance is a significant predictor of vascular dysfunction in the HIV population.
  • Managing insulin resistance may be crucial for mitigating CVD risk in people with HIV.
Abstract

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