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Gut permeability is associated with lower insulin sensitivity in youth with perinatally acquired HIV.
- Source :
-
AIDS (London, England) [AIDS] 2024 Jul 01; Vol. 38 (8), pp. 1163-1171. Date of Electronic Publication: 2024 Mar 28. - Publication Year :
- 2024
-
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.<br /> (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Male
Adolescent
Female
Child
Puerto Rico
Protein Precursors blood
United States
Carrier Proteins blood
Cholera Toxin blood
Membrane Glycoproteins blood
Permeability
Acute-Phase Proteins analysis
Viral Load
HIV Infections
Insulin Resistance
Fatty Acid-Binding Proteins blood
Haptoglobins analysis
Haptoglobins metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5571
- Volume :
- 38
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- AIDS (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 38564437
- Full Text :
- https://doi.org/10.1097/QAD.0000000000003896