Original scientific paper
https://doi.org/10.3325/cmj.2013.54.330
Ultrasound measurements of carotid intima-media thickness and plaque in HIV-infected patients on the Mediterranean diet
Klaudija Višković
orcid.org/0000-0002-5927-3201
; Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Zagreb, Croatia
George W. Rutherford
; Global Health Sciences, University of California, San Francisco, CA, USA
Lorna Stemberger
orcid.org/0000-0001-5523-0426
; Outpatient Center for HIV/AIDS University Hospital for Infectious Diseases, Zagreb, Croatia
Zoran Brnić
; University of Zagreb School of Medicine, Zagreb, Croatia
Josip Begovac
; University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
Aim To evaluate the influence of food habits, specifically
adherence to the Mediterranean diet, on carotid intimamedia
thickness (CIMT) and the presence of plaques in
HIV-infected patients taking antiretroviral therapy (ART)
and non-HIV-infected participants and to determine if HIV
infection contributes independently to subclinical atherosclerosis.
Methods We conducted a cross-sectional study of 110
HIV-infected patients on ART and 131 non-HIV-infected
participants at the University Hospital for Infectious Diseases
in Zagreb, Croatia, from 2009-2011. CIMT measurement
and determination of carotid plaque presence was
detected by ultrasound. Adherence to the Mediterranean
diet was assessed by a 14-point food-item questionnaire.
Subclinical atherosclerosis was defined by CIMT≥0.9 mm
or ≥1 carotid plaque.
Results In HIV-infected patients, subclinical atherosclerosis
was associated with older age (P < 0.001; Mann-Whitney
test), higher body mass index (P = 0.051; Mann-Whitney
test), hypertension (P < 0.001; χ2 test), and a lower Mediterranean
diet score (P = 0.035; Mann-Whitney test), and
in non-HIV-infected participants with older age (P < 0.001;
Mann-Whitney test) and hypertension (P = 0.006; χ2 test).
Multivariate analysis showed that decreased adherence to
the Mediterranean diet was associated with higher odds
of subclinical atherosclerosis (odds ratio [OR] 2.28, 95%
confidence interval [CI] 1.10-4.72, P = 0.027) as was current
smoking (OR 2.86, 95% CI 1.28-6.40), hypertension (OR
3.04, 95% CI 1.41-6.57), and male sex (OR 2.35, 95% CI 0.97-
5.70). There was a significant interaction of age and HIV status,
suggesting that older HIV-infected patients had higher
odds of subclinical atherosclerosis than controls (OR 3.28,
95% CI 1.24-8.71, P = 0.017 at the age of 60 years).
Conclusion We confirmed the association between lower
adherence to the Mediterranean diet and increased risk of
subclinical atherosclerosis and found that treated HIV infection
was a risk factor for subclinical atherosclerosis in
older individuals.
Keywords
Hrčak ID:
108671
URI
Publication date:
15.8.2013.
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