The relationship of gamma-glutamyltransferase to arterial stiffness in HIV patients

Pedro Martínez-Ayala; Guillermo Adrián Alanis-Sánchez; Luz Alicia González-Hernández; Jaime Federico Andrade-Villanueva; Carlos Ramos-Becerra; Ruth Lisbeth Ibarra-Jiménez; Manuel Andrey Félix-Castro; Raúl Soria-Rodríguez; Octavio Ponce-Orozco; David Cardona-Müller; Ernesto Germán Cardona-Muñoz; Aldo Daniel Loza-Salazar; Diego Francisco González-Peña; Nicolás Serrano-Suárez

2018, Number 4

Rev Med MD 2018; 9.10 (4)

The relationship of gamma-glutamyltransferase to arterial stiffness in HIV patients

Martínez-Ayala P, Alanis-Sánchez GA, González-Hernández LA, Andrade-Villanueva JF, Ramos-Becerra C, Ibarra-Jiménez RL, Félix-Castro MA, Soria-Rodríguez R, Ponce-Orozco O, Cardona-Müller D, Cardona-Muñoz EG, Loza-Salazar AD, González-Peña DF, Serrano-Suárez N

Full text

How to cite this article

Language: Spanish
References: 30
Page: 299-304
PDF size: 592.63 Kb.

ABSTRACT

Introduction. With modern antiretroviral therapy, early diagnosis and treatment, life expectancy of human immunodeficiency virus (HIV)-infected subjects is similar to that of the general population. As a result, cardiovascular disease (CVD) in HIV, besides having a higher incidence, is also the most common cause of death among subjects receiving antiretroviral therapy. However, it is not clear to which degree the associated inflammatory state and the adverse effects of antiretroviral therapy contribute to this higher risk of CDV. For this reason, identification of subclinical changes in the CV system, such as arterial stiffness, is important for a correct cardiovascular risk evaluation in newly diagnosed HIV individuals. Carotid-femoral pulse wave velocity (cfPWV) is an independent biomarker of CVD and is considered the gold standard to assess arterial stiffness. For this reason, the aim of the present study was to evaluate the association of traditional cardiovascular risk factors, immunological state, viral load, hepatic and renal function with cfPWV in HIV individuals without treatment (naïve).
Material and Methods. We conducted a cross-sectional study in HIV naïve patients. We measured cfPWV by aplanation tonometry as marker of arterial stiffness. Likewise, we assessed the associations between viral load (number of viral copies), immunological state (T CD4 and CD8 lymphocytes), serum lipids (total cholesterol, triglycerides, and low and high density lipoproteins), C-reactive protein (PCR), and kidney (serum creatinine and creatinine clearance) and liver function (albumin, gamma-glutamyltransferase, aspartate aminotransferase and alanine transaminase).
Results. Fifty-one individuals (90.2% males) were included in the study. Mean age was 33±10 years old with a smoking prevalence of 70.5%. Additionally, individuals had a prevalence of high density lipoprotein below 40 mg/dl of 79.5%. We found a positive association between gamma-glutamyl transferase and cfPWV (rho=0.399, p‹0.01). However, we did not observe any associations between the rest of the parameters of kidney function, serum lipids, immunological state, viral load or PCR with arterial stiffness.
Discussion. Individuals HIV treatment naïve exhibited an association between arterial stiffness and GGT, a contributor of oxidative stress. The traditional risk factors, together with parameters of viral load, immunological state, smoking habits, liver and renal function were not associated with arterial stiffness.

REFERENCES

Lewden C, Chêne G, Morlat P, Raffi F, Dupon M, Dellamonica P, et al. HIV-infected adults with a CD4 cell count greater than 500 cells/mm3 on long-term combination antiretroviral therapy reach same mortality rates as the general population. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2007;46(1):72-7.
2.Sackoff JE, Hanna DB, Pfeiffer MR, Torian LV. Causes of death among persons with AIDS in the era of highly active antiretroviral therapy: New York City. Annals of internal medicine. 2006;145(6):397- 406.
3.Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318-27.
4.Freiberg M, Chang C, Kuller L, Skanderson M, Lowy E, Kraemer K, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013; 173: 614–22.
5.Anne-Lise P, Chang C-CH, So-Armah KA, Butt AA, Leaf D A, BudoffM, et al. Human immunodeficiency virus infection, cardiovascular risk factor profile and risk for acute myocardial infarction. Journal of acquired immune deficiency syndromes (1999). 2015;68(2):209.
6.Papita A, Albu A, Fodor D, Itu C, Cârstina D. Arterial stiffness and carotid intima-media thickness in HIV infected patients. Medical ultrasono graphy. 2011;13(2):127.
7.van Wijk JP, de Koning EJ, Cabezas MC, Joven J, op't Roodt J, Rabelink TJ, et al. Functional and structural markers of a the rosclerosis inhuman immunodeficiency virus-infected patients. Journal of the American College of Cardiology. 2006;47(6):1117- 23.
8.Schillaci G, De Socio GV, Pirro M, Savarese G, Mannarino MR, Baldelli F, et al. Impact of treatment with protease inhibitors on aortic stiffness in adult patients with human immunodeficiency virus infection. Arteriosclerosis, thrombosis, and vascular biology. 2005;25(11):2381-5.
9.Schillaci G, De Socio GV, Pucci G, Mannarino MR, Helou J, Pirro M, et al. Aortic stiffness in untreated adult patients with human immunodeficiency virus infection. Hypertension. 2008;52(2):308-13.
10.Seaberg EC, Benning L, Sharrett AR, Lazar JM, Hodis HN, Mack WJ, et al. Association between human immunodeficiency virus infection and stiffness of the common carotid artery. Stroke. 2010;41(10):2163-70.
11.Van Bor tel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank J, De Backer T, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. Journal of hypertension. 2012;30(3):445-8.
12.Friis-Møller N, Sabin C, Weber R, El-Sadr W, Reiss P, Thiebaut R, et al. Combination Antiretroviral Therapy and the Risk of Myocardial Infarction. The Data Collection on Adverse Events of Anti-HIV Drugs for the D: A: D Study Group. New England Journal of Medicine. 2003.
13.Currier JS, Taylor A, Boyd F, Dezii CM, Kawabata H, Burtcel B, et al. Coronary heart disease in HIVinfected individuals. Journal of acquired immune deficiency syndromes (1999). 2003;33(4):506-12.
14.Bozzette SA, Ake CF, Tam HK, Chang SW, Louis TA. Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. New England Journal of Medicine. 2003;348(8):702-10.
15.Carr A, Grund B, Neuhaus J, El-Sadr WM, Grandits G, Gibert C, et al. Asymptomatic myocardial is chaemiain HIV-infected adults. Aids. 2008;22(2):257-67.
16.Group SfMoATS. CD4+ count–guided interruption of antiretroviral treatment. New England Journal of Medicine. 2006;355(22):2283-96.
Castellano I, Merlino A. γ-Glutamyltranspeptidases: sequence, structure, biochemical properties, and biotechnological applications. Cellular and molecular life sciences. 2012;69(20):3381-94.
18.Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H. γ-Glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163 944 Austrian adults. Circulation. 2005;112(14):2130-7.
19.Paolicchi A, Minotti G, Tonarelli P, Tongiani R, De D C, Mezzetti A, et al. Gamma-glutamyl transpeptidase-dependent iron reduction and LDL oxidation--a potential mechanism in atherosclerosis. Journal of investigative medicine. 1999;47(3):151-60.
20.Frey A, Meckelein B, Weiler-güttler H, Möckel B, Flach R, Gassen Hg. Pericytes of the brain microvasculature express γglutamyl transpeptidase. The FEBS Journal. 1991;202(2):421-9.
21.Go Y-M, Jones DP. Intracellular proatherogenic events and cell adhesion modulated by extracellular thiol/disulfideredoxstate. Circulation. 2005;111(22):2973-80.
22.Kim K-N, Kim K-M, Lee D-J, Joo N-S. Serum g amma - glutamyl transferase concentration correlates with Framingham risk score in Koreans. Journal of Korean medical science. 2011;26(10):1305-9.
23.Zhu C, Xiong Z, Zheng Z, Chen Y, Qian X, Chen X. Association of serum gamma-glutamyltransferase with arterial stiffness in established coronary artery disease. Angiology. 2013;64(1):15-20.
24.Saijo Y, Utsugi M, Yoshioka E, Horikawa N, Sato T, Gong Y, et al. The relationship of gammaglutamyltransferase to C-reactive protein and arterial stiffness. Nutrition, Metabolism and Cardiovascular Diseases. 2008;18(3):211-9.
25.Ndrepepa G, Braun S, Schunkert H, Laugwitz K-L, Kastrati A. Gamma-glutamyl transferase and prognosis in patients with coronary artery disease. Clinica Chimica Acta. 2016;452:155-60.
26.Kengne AP, Czernichow S, Stamatakis E, Hamer M, Batty GD. Gamma-glutamyltransferase and risk of cardiovascular disease mortality in people with and without diabetes: pooling of three British Health Surveys. Journal of hepatology. 2012;57(5):1083-9.
27.Kunutsor SK, Bakker SJ, Kootstra-Ros JE, Gansevoort RT, Dullaart RP. Circulating gamma glutamyltransferase and prediction of cardiovascular disease. Atherosclerosis. 2015;238(2):356-64.
28.Markert MS, Della-Morte D, Cabral D, Roberts EL, Gardener H, Dong C, et al. Ethnic differences in carotid artery diameter and stiffness: the Northern Manhattan Study. Atherosclerosis. 2011;219(2):827- 32.
29.Salinas CAA, Pérez FJG, Garber IL, Chávez CV, Méndez ÓP, Romero CP. Diagnóstico y tratamiento de las dislipidemias: posición de la Sociedad Mexicana de Endocrinología. Revista de Endocrinología y nutrición. 2004;12(1):7-41.
30.Ridker PM, Danielson E, Fonseca F, Genest J, Gotto Jr AM, Kastelein J, et al. Rosuvastatin to prevent vascular events in men and women with elevated Creactive protein. New England Journal of Medicine. 2008;359(21):2195.