Lipid accumulation product index in HIV-infected patients: a marker of cardiovascular risk
Guimarães, Milena Maria Moreira; Greco, Dirceu Bartolomeu; Moreira, Allyson Nogueira; Guimarães, Nathalia Sernizon; Freire, Cláudia Maria Vilas; Rohlfs, Bruna Guimarães; Machado, Lucas José de Campos.
Braz. j. infect. dis;
22(3): 171-176, May-June 2018. tab, graf
Artículo
en Inglés
| LILACS | ID: biblio-974213
ABSTRACT The lipid accumulation product (LAP) index is an emerging cardiovascular risk marker. We aimed to assess the accuracy of this index as a marker of cardiovascular risk in HIV-infected patients. A cross-sectional study of 133 HIV-infected patients on antiretroviral drugs and 20 non-infected controls was conducted at the outpatient clinic of a referral center of infectious and parasitic diseases. Evaluations included LAP index, homeostasis model assessment (HOMA) index, anthropometric measurements, blood pressure, glucose tolerance test, and cholesterol and triglyceride levels. Body mass index (BMI) was similar in both groups; however, waist circumference was greater in the HIV-infected patients. Triglyceride levels were significantly higher (p < 0.001) and HDL cholesterol levels were lower in HIV-infected patients (p < 0.001). Plasma glucose (p = 0.01) and insulin (p = 0.005) levels two hours after a glucose load, HOMA-IR index (p < 0.001) and LAP index (p < 0.001) were higher in the HIV-infected patients. A positive and significant correlation was found between HOMA-IR index and LAP (r = 0.615; p < 0.01), BMI (r = 0.334; p < 0.01) and waist circumference (r = 0.452; p < 0.01) in the HIV-infected patients. In male HIV-infected patients and controls, ROC curve analyses revealed that the best cut-off value of LAP to define the presence of insulin resistance was 64.8 (sensitivity 86%, specificity 77% and area under the curve 0.824). These results confirm that insulin resistance is more common in HIV-patients on antiretroviral drugs than in HIV-negative controls. A positive and significant correlation was found between the LAP index and the HOMA index, with LAP ≥ 64.8 constituting an additional risk factor for cardiovascular disease in male HIV patients.
Asunto(s)
Humanos Masculino Femenino Adolescente Adulto Persona de Mediana Edad Adulto Joven Enfermedades Cardiovasculares/etiología Infecciones por VIH/complicaciones Medición de Riesgo/métodos Terapia Antirretroviral Altamente Activa/efectos adversos Producto de la Acumulación de Lípidos/fisiología Valores de Referencia Triglicéridos/sangre Glucemia/análisis Resistencia a la Insulina/fisiología Biomarcadores/análisis Enfermedades Cardiovasculares/diagnóstico Índice de Masa Corporal Infecciones por VIH/tratamiento farmacológico Factores Sexuales Colesterol/sangre Estudios Transversales Estudios Retrospectivos Factores de Riesgo Sensibilidad y Especificidad Estadísticas no Paramétricas Insulina/sangre
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