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Gut permeability is associated with lower insulin sensitivity in youth with perinatally acquired HIV.
Dirajlal-Fargo, Sahera; Yu, Wendy; Jacobson, Denise L; Mirza, Ayesha; Geffner, Mitchell E; Jao, Jennifer; McComsey, Grace A.
Afiliação
  • Dirajlal-Fargo S; Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, Ohio.
  • Yu W; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
  • Jacobson DL; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Mirza A; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Geffner ME; University of Florida Health, Jacksonville, Florida.
  • Jao J; The Saban Research Institute of Children's Hospital Los Angeles, Los Angeles, California.
  • McComsey GA; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
AIDS ; 38(8): 1163-1171, 2024 07 01.
Article em En | MEDLINE | ID: mdl-38564437
ABSTRACT
The relationships between alterations in the intestinal barrier, and bacterial translocation with the development of metabolic complications in youth with perinatally acquired HIV (YPHIV) have not been investigated. The PHACS Adolescent Master Protocol enrolled YPHIV across 15 U.S. sites, including Puerto Rico, from 2007 to 2009. For this analysis, we included YPHIV with HIV viral load 1000 c/ml or less, with at least one measurement of homeostatic assessment of insulin resistance (HOMA-IR) or nonhigh density lipoprotein (non-HDLc) between baseline and year 3 and plasma levels of intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide-binding protein (LBP), and zonulin levels at baseline. We fit linear regression models using generalized estimating equations to assess the association of baseline log 10 gut markers with log 10 HOMA-IR and non-HDLc at all timepoints. HOMA-IR or non-HDLc was measured in 237, 189, and 170 PHIV at baseline, Yr2, and Yr3, respectively. At baseline, median age (Q1, Q3) was 12 years (10, 14), CD4 + cell count was 762 cells/µl (574, 984); 90% had HIV RNA less than 400 c/ml. For every 10-fold higher baseline I-FABP, HOMA-IR dropped 0.85-fold at baseline and Yr2. For a 10-fold higher baseline zonulin, there was a 1.35-fold increase in HOMA-IR at baseline, 1.23-fold increase in HOMA-IR at Yr2, and 1.20-fold increase in HOMA-IR at Yr3 in adjusted models. For a 10-fold higher baseline LBP, there was a 1.23-fold increase in HOMA-IR at baseline in the unadjusted model, but this was slightly attenuated in the adjusted model. Zonulin was associated with non-HDLc at baseline, but not for the other time points. Despite viral suppression, intestinal damage may influence downstream insulin sensitivity in YPHIV.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Haptoglobinas / Resistência à Insulina / Infecções por HIV / Proteínas de Ligação a Ácido Graxo Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte / Caribe / Puerto rico Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Haptoglobinas / Resistência à Insulina / Infecções por HIV / Proteínas de Ligação a Ácido Graxo Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte / Caribe / Puerto rico Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido