MASLD in persons with HIV is associated with high cardiometabolic risk as evidenced by altered advanced lipoprotein profiles and targeted metabolomics.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Lipids in Health and Disease Pub Date : 2024-10-17 DOI:10.1186/s12944-024-02317-4

Kung-Hung Lin, Eduardo Vilar-Gomez, Kathleen E Corey, Margery A Connelly, Samir K Gupta, Jordan E Lake, Naga Chalasani, Samer Gawrieh

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引用次数: 0

Abstract

Background: Metabolic dysfunction associated steatotic liver disease (MASLD) is associated with increased cardiovascular disease (CVD) risk in persons with HIV (PWH). The lipidomic and metabolomic alterations contributing to this risk are poorly understood. We aimed to characterize the advanced lipoprotein and targeted metabolomic profiles in PWH and assess if the presence and severity of MASLD influence these profiles.

Methods: This is a cross-sectional analysis of a prospectively enrolled multicenter cohort. PWH without alcohol abuse or known liver disease underwent vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Lipidomic and metabolomic profiling was undertaken with nuclear magnetic resonance (NMR) spectroscopy. Hepatic steatosis was defined as CAP ≥ 263 dB/m and clinically significant fibrosis (CSF) as LSM ≥ 8 kPa. Logistic regression models assessed associations between MASLD, CSF and lipidomic and metabolic parameters.

Results: Of 190 participants (71% cisgender male, 96% on antiretroviral therapy), 58% had MASLD and 12% CSF. Mean (SD) age was 48.9 (12.1) years and body mass index (BMI) 29.9 (6.4) kg/m². Compared to PWH without MASLD (controls), PWH with MASLD had lower HDL-C but higher total triglyceride, VLDL-C, branched-chain amino acids, GlycA, trimethylamine N-oxide levels, Lipoprotein-Insulin Resistance and Diabetes Risk Indices. There were no significant differences in these parameters between participants with MASLD with or without CSF. In a multivariable regression analysis, MASLD was independently associated with changes in most of these parameters after adjustment for age, gender, race/ethnicity, type 2 diabetes mellitus, BMI, and lipid lowering medications use.

Conclusions: MASLD in PWH is independently associated with altered advanced lipoprotein and targeted metabolic profiles, indicating a higher CVD risk in this population.

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艾滋病病毒感染者的 MASLD 与高心脏代谢风险有关，高级脂蛋白谱和靶向代谢组学的改变证明了这一点。

背景：代谢功能障碍相关性脂肪性肝病（MASLD）与艾滋病病毒感染者（PWH）心血管疾病（CVD）风险增加有关。人们对导致这种风险的脂质体和代谢体改变知之甚少。我们的目的是描述艾滋病感染者的高级脂蛋白和目标代谢组学特征，并评估 MASLD 的存在和严重程度是否会影响这些特征：这是一项前瞻性多中心队列的横断面分析。没有酗酒或已知肝病的肥胖症患者接受了振动控制瞬态弹性成像，以测量控制衰减参数（CAP）和肝脏硬度（LSM）。利用核磁共振（NMR）光谱进行了脂质体和代谢组分析。肝脏脂肪变性的定义是 CAP ≥ 263 dB/m，临床上明显的肝纤维化（CSF）的定义是 LSM ≥ 8 kPa。逻辑回归模型评估了 MASLD、CSF 与脂质体和代谢参数之间的关联：在 190 名参与者（71% 为男性，96% 接受抗逆转录病毒治疗）中，58% 患有 MASLD，12% 患有 CSF。平均（标清）年龄为 48.9 (12.1) 岁，体重指数 (BMI) 为 29.9 (6.4) kg/m2。与未患有 MASLD 的 PWH（对照组）相比，患有 MASLD 的 PWH 高密度脂蛋白胆固醇含量较低，但总甘油三酯、VLDL-C、支链氨基酸、GlycA、三甲胺 N-氧化物水平、脂蛋白-胰岛素抵抗和糖尿病风险指数较高。有或没有 CSF 的 MASLD 患者在这些参数上没有明显差异。在多变量回归分析中，在对年龄、性别、种族/民族、2型糖尿病、体重指数和降脂药物使用情况进行调整后，MASLD与大多数参数的变化都有独立关联：PWH 中的 MASLD 与高级脂蛋白和目标代谢特征的改变独立相关，表明该人群的心血管疾病风险较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.