Matteo Pirro1, Vanessa Bianconi2, Elisabetta Schiaroli3, Daniela Francisci3, Massimo R Mannarino2, Francesco Bagaglia2, Amirhossein Sahebkar4, Tony Merriman5, Franco Baldelli3. 1. Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy. Electronic address: matteo.pirro@unipg.it. 2. Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, 06129, Italy. 3. Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, 06129, Italy. 4. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran. 5. Department of Biochemistry, University of Otago, Dunedin, 9054, New Zealand.
Abstract
BACKGROUND AND AIMS: Elevated serum uric acid (SUA) levels may be associated with endothelial dysfunction. Increased rates of metabolic syndrome (MS) and elevated SUA levels were described in human immunodeficiency virus (HIV) infected patients. We investigated whether SUA levels are associated with endothelial dysfunction in HIV positive patients receiving highly-active antiretroviral therapy (HAART) irrespective of MS. METHODS: In this cross-sectional study of 250 HIV positive patients receiving stable HAART, we evaluated the relationship between MS, SUA levels and endothelial function. SUA levels and brachial artery flow-mediated dilation (bFMD) were measured. The relationship between logarithmic (LG)-transformed SUA levels and bFMD was evaluated after correction for MS. RESULTS: MS was detected in 28.4% of patients and elevated SUA levels (≥6 mg/dL) in 25.2%. MS was associated with higher LG-SUA levels (age-, gender- and glomerular filtration rate-adjusted beta = 0.204, p = 0.001). The crude linear association between LG-SUA levels and LG-bFMD (beta = -0.166, p = 0.008) was abolished after correction for MS (beta = -0.089, p = 0.172). When SUA levels were used as a categorical variable (≥6 mg/dL or <6 mg/dL and SUA quartiles, respectively), the association between LG-SUA levels and LG-bFMD remained significant after adjustment for MS (beta = -0.142, p = 0.022 and beta = -0.163, p = 0.010, respectively). CONCLUSIONS: MS significantly affects SUA levels in HAART-treated HIV infected patients. The negative association between SUA and bFMD is independent of MS only for elevated SUA levels.
BACKGROUND AND AIMS: Elevated serum uric acid (SUA) levels may be associated with endothelial dysfunction. Increased rates of metabolic syndrome (MS) and elevated SUA levels were described in human immunodeficiency virus (HIV) infectedpatients. We investigated whether SUA levels are associated with endothelial dysfunction in HIV positive patients receiving highly-active antiretroviral therapy (HAART) irrespective of MS. METHODS: In this cross-sectional study of 250 HIV positive patients receiving stable HAART, we evaluated the relationship between MS, SUA levels and endothelial function. SUA levels and brachial artery flow-mediated dilation (bFMD) were measured. The relationship between logarithmic (LG)-transformed SUA levels and bFMD was evaluated after correction for MS. RESULTS: MS was detected in 28.4% of patients and elevated SUA levels (≥6 mg/dL) in 25.2%. MS was associated with higher LG-SUA levels (age-, gender- and glomerular filtration rate-adjusted beta = 0.204, p = 0.001). The crude linear association between LG-SUA levels and LG-bFMD (beta = -0.166, p = 0.008) was abolished after correction for MS (beta = -0.089, p = 0.172). When SUA levels were used as a categorical variable (≥6 mg/dL or <6 mg/dL and SUA quartiles, respectively), the association between LG-SUA levels and LG-bFMD remained significant after adjustment for MS (beta = -0.142, p = 0.022 and beta = -0.163, p = 0.010, respectively). CONCLUSIONS: MS significantly affects SUA levels in HAART-treated HIV infectedpatients. The negative association between SUA and bFMD is independent of MS only for elevated SUA levels.
Authors: Vinita Subramanya; Heather S McKay; Rebeccah M Brusca; Frank J Palella; Lawrence A Kingsley; Mallory D Witt; Howard N Hodis; Russell P Tracy; Wendy S Post; Sabina A Haberlen Journal: PLoS One Date: 2019-04-04 Impact factor: 3.752