Document Detail


Intensive lifestyle modification reduces Lp-PLA2 in dyslipidemic HIV/HAART patients.
MedLine Citation:
PMID:  23299761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Patients with dyslipidemia associated with HIV-1 infection and highly active antiretroviral therapy (HAART) have elevated levels of Lp-PLA2 and CCL5/regulated on activation, normal T-cell expressed and secreted (RANTES), which may increase the risk of cardiovascular disease.
PURPOSE: This study aimed to determine whether an intensive diet and exercise (D/E) program, independently or combined with fenofibrate or niacin, could reduce Lp-PLA2 or RANTES.
METHODS: Patients with hypertriglyceridemic HIV on stable HAART (n = 107) were randomized to one of five interventions: 1) usual care, 2) D/E with placebos, 3) D/E with fenofibrate and placebo, 4) D/E with niacin and placebo, or 5) D/E with fenofibrate and niacin for 24 wk. Lp-PLA2 and RANTES concentrations were measured in fasting plasma samples at baseline and postintervention. General linear models were used to compare Lp-PLA2 and RANTES levels between the five groups postintervention, controlling for baseline levels, age, body mass index, CD4 T-cell count, viral load, duration of infection, and HAART.
RESULTS: At baseline, fasting plasma Lp-PLA2 (388.5 ± 127.5 ng·mL) and RANTES (43.8 ± 25.5 ng·mL) levels were elevated when compared with healthy controls. Posttreatment Lp-PLA2 mass was lower in patients who received D/E only (323.0 ± 27.2 ng·mL), D/E plus fenofibrate (327.2 ± 25.9 ng·mL), and D/E plus niacin (311.1 ± 27.8 ng·mL) when compared with patients receiving usual care (402.2 ± 25.3 ng·mL). RANTES concentrations were not significantly affected by any intervention.
CONCLUSIONS: Elevated plasma Lp-PLA2 mass can be reduced by an intensive D/E program in patients with HIV/HAART-associated dyslipidemia. RANTES is elevated but is not reduced by lifestyle modification, fenofibrate, or niacin.
Authors:
Joshua S Wooten; Preethi Nambi; Baiba K Gillard; Henry J Pownall; Ivonne Coraza; Lynne W Scott; Vijay Nambi; Christie M Ballantyne; Ashok Balasubramanyam
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  45     ISSN:  1530-0315     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-20     Completed Date:  2014-02-03     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1043-50     Citation Subset:  IM; S    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00246376
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MeSH Terms
Descriptor/Qualifier:
1-Alkyl-2-acetylglycerophosphocholine Esterase / blood*
Adult
Aged
Antiretroviral Therapy, Highly Active*
Biological Markers / blood
Chemokine CCL5 / blood
Combined Modality Therapy
Diet Therapy* / methods
Double-Blind Method
Drug Administration Schedule
Exercise Therapy* / methods
Female
Fenofibrate / therapeutic use
HIV Infections / blood,  complications*,  drug therapy
HIV-1*
Humans
Hypertriglyceridemia / blood,  etiology,  therapy*
Hypolipidemic Agents / therapeutic use
Life Style
Linear Models
Male
Middle Aged
Niacin / therapeutic use
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL56865/HL/NHLBI NIH HHS; P30 DK079638/DK/NIDDK NIH HHS; P30DK079638/DK/NIDDK NIH HHS; R01 HL030914/HL/NHLBI NIH HHS; R01 HL056865/HL/NHLBI NIH HHS; R01 HL073696/HL/NHLBI NIH HHS; R01 HL30914/HL/NHLBI NIH HHS; R01 HL73696/HL/NHLBI NIH HHS; T32 HL007812/HL/NHLBI NIH HHS; T32 HL07812/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/CCL5 protein, human; 0/Chemokine CCL5; 0/Hypolipidemic Agents; 59-67-6/Niacin; EC 3.1.1.47/1-Alkyl-2-acetylglycerophosphocholine Esterase; U202363UOS/Fenofibrate
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