High Irisin levels in nondiabetic HIV-infected males are associated with insulin resistance, nonalcoholic fatty liver disease, and subclinical atherosclerosis

被引:20
作者
Moreno-Perez, Oscar [1 ,2 ,3 ]
Reyes-Garcia, Rebeca [4 ,5 ]
Munoz-Torres, Manuel [4 ]
Merino, Esperanza [2 ,3 ,6 ]
Boix, Vicente [2 ,3 ,6 ]
Reus, Sergio [2 ,3 ,6 ]
Giner, Livia [2 ,3 ,6 ]
Alfayate, Rocio [3 ,7 ]
Garcia-Fontana, Beatriz [4 ]
Sanchez-Paya, Jose [3 ,8 ]
Pico, Antonio [1 ,2 ,3 ]
Portilla, Joaquin [2 ,3 ,6 ]
机构
[1] Univ Gen Hosp Alicante, Endocrinol & Nutr Serv, C Maestro Alonso S-N, Alicante 03010, Spain
[2] Univ Miguel Hernandez, Dept Clin Med, C Maestro Alonso S-N, Alicante 03010, Spain
[3] Inst Invest Sanitaria & Biomed Alicante ISABIAL F, C Maestro Alonso S-N, Alicante 03010, Spain
[4] Complejo Hosp Univ Granada, Bone Metab Unit RETICEF, UGC Endocrinol & Nutr, Inst Invest Biosanitaria ibs, Granada, Spain
[5] Complejo Hosp Torrecardenas, Endocrinol Serv, Almeria, Spain
[6] Univ Gen Hosp Alicante, Infect Dis Unit, Alicante, Spain
[7] Univ Gen Hosp Alicante, Hormone Lab, Alicante, Spain
[8] Univ Gen Hosp Alicante, Prevent Med Dept, Alicante, Spain
关键词
cardiovascular; carotid intima-media thickness; HIV; insulin homeostasis; irisin; nonalcoholic fatty liver disease; subclinical atherosclerosis; INDEPENDENT PREDICTOR; DIABETES-MELLITUS; MYOKINE IRISIN; PREVALENCE; OBESITY; ADULTS; SERUM; RISK;
D O I
10.1111/cen.13800
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveHIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, nonalcoholic fatty liver disease (NAFLD) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV-infected males. DesignCross-sectional study in a cohort of HIV-infected patients. PatientsInclusion criteria: men older than 18years; antiretroviral therapy (ART) -naive or on effective ART (<50 HIV-1 RNAcopies/mL) without changes in the previous 6months; no diabetes or hepatitis C. MeasurementsIrisin was measured by enzymatic immunoassay (Phoenix Pharmaceuticals), insulin sensitivity by homeostasis model assessment of insulin resistance (HOMA-IR), as well as the 2-hour continuous infusion of glucose with model assessment (CIGMA-HOMA). Hepatic steatosis was measured by 1-H magnetic resonance spectroscopy, subclinical atherosclerosis by evaluation of carotid intima-media thickness (C-IMT), measured by Ultrasonography. ResultsEight nine men (age 42.08.3years, duration of HIV infection 7.9 +/- 5.6years, CD4 count 547 +/- 279cells/mL) were included. Circulating irisin was positively related to HOMA-IR and CIGMA-HOMA, hepatic triglyceride content, and to VAT/SAT ratio. Higher irisin concentrations were associated with higher C-IMT, although this association did not persist in multivariate analysis. Lipodystrophy and a higher baseline PAI-1 concentration were independently associated with C-IMT. ConclusionsIn male HIV patients without diabetes, higher irisin concentrations are positively associated with insulin resistance, NAFLD and subclinical atherosclerosis. However, waist-hip-ratio is the main determinant of insulin resistance, and PAI-1 and lipodystrophy were the strongest determinants of IMT in this population.
引用
收藏
页码:414 / 423
页数:10
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