Cystatin C, Adipokines and Cardiovascular Risk in HIV Infected Patients

Objectives: To value the role of leptin, adiponectin and cystatin C in HIV infected patients treated with combined antiretroviral therapy (cART) subdivided for cardiovascular risk (CVR). Methods: 56 HIV+ cART treated patients were screened by Framingham score and subdivided in 2 groups: A) 15 with "high" CVR (>10%) and B) 41 with "low" CVR (<10%). Viro-immunological parameters, triglycerides, total cholesterol, HDL and LDL cholesterol, blood pressure, microalbuminuria, fasting glucose, insulinemia, HOMA-IR, CRP, cystatin C, IL-18, IL-6, leptin, adiponectin, antropometric parameters and total abdominal tissue (TAT), subcutaneous (SAT) and visceral abdominal tissue (VAT) were measured. Results: Group A showed statistically higher levels of parameters of glucose and lipid metabolism, cystatin C, microalbuminuria, blood pressure and BMI. Moreover levels of IL-6, IL-18 and leptin were statistically higher in group A, whereas adiponectin was statistically increased in group B. Data showed a positive correlation between VAT, leptin levels (r=0.37, p=0.005) and IL-18 (r=0.32, p=0.01), and a negative correlation between VAT and adiponectin (r=-0.30, p=0.02). Finally group A showed statistically higher levels of cystatin C and there was a positive correlation between CVR and cystatin C (r=0.39, p=0.003). Conclusions: The main results of this study are that HIV positive subjects cART treated with "high" CVR have increased plasma levels of leptin, IL-6, IL-18 and cystatin C and hypoadiponectinemia. Moreover, the positive correlation between CVR and cystatin C found in this study for the first time in HIV positive patients, indicates that cystatin C could serve as early marker of enhanced CVR in the HIV-infected population.