CVD Biomarker Identified in Men With HIV

A lipid accumulation product (LAP) index of at least 64.8 signifies the presence of insulin resistance and an increased risk of cardiovascular disease (CVD) in men with human immunodeficiency virus (HIV), according to a new study.

For their study, the researchers evaluated 133 patients with HIV receiving antiretroviral therapy (ART), along with 20 healthy controls.
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Specifically, LAP index, homeostasis model assessment (HOMA) index, anthropometric measurements, blood pressure, a glucose tolerance test, and cholesterol and triglyceride levels were assessed.

Findings showed that, although body mass index (BMI) was similar between groups, waist circumference tended to be greater among patients with HIV. However, triglyceride levels and high-density lipoprotein cholesterol levels were found to be lower in patients with HIV compared with those without HIV.

The researchers also found that HOMA-insulin resistance (HOMA-IR) index and LAP index tended to be higher in patients with HIV. Notably, they observed a positive and significant correlation between HOMA-IR index and LAP, BMI, and waist circumference in the HIV group.

Results of ROC curve analyses indicated that 64.8 (sensitivity 86%; specificity 77%; area under the curve 0.824) was the best cut-off value of LAP to define the presence of insulin resistance particularly in men with HIV.

“These results confirm that insulin resistance is more common in HIV-patients on antiretroviral drugs than in HIV-negative controls,” the researchers concluded. “A positive and significant correlation was found between the LAP index and the HOMA index, with LAP [of at least 64.8] constituting an additional risk factor for cardiovascular disease in male HIV patients.”

—Christina Vogt

Reference:

Guimarães MMM, Greco DB, Nogueira Moreira A, et al. Lipid accumulation product index in HIV-infected patients: a marker of cardiovascular risk [Published online April 22, 2018]. Braz J Infect Dis. https://doi.org/10.1016/j.bjid.2018.03.006

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