Lipoprotein(a) and HIV: Allele-specific apolipoprotein(a) levels predict carotid intima-media thickness in hiv-infected young women in the women's interagency HIV study

Byambaa Enkhmaa, Erdembileg Anuurad, Wei Zhang, Chin Shang Li, Robert Kaplan, Jason Lazar, Dan Merenstein, Roksana Karim, Brad Aouizerat, Mardge Cohen, Kenneth Butler, Savita Pahwa, Igho Ofotokun, Adaora A. Adimora, Elizabeth Golub, Lars Berglund

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective - In the general population, lipoprotein(a) [Lp(a)] has been established as an independent causal risk factor for cardiovascular disease. Lp(a) levels are to a major extent regulated by a size polymorphism in the apolipoprotein(a) [apo(a)] gene. The roles of Lp(a)/apo(a) in human immunodeficiency virus (HIV)-related elevated cardiovascular disease risk remain unclear. Approach and Results - The associations between total plasma Lp(a) level, allele-specific apo(a) level, an Lp(a) level carried by individual apo(a) alleles, and common carotid artery intima-media thickness were assessed in 150 HIV-infected and 100 HIV-uninfected women in the WIHS (Women's Interagency HIV Study). Linear regression analyses with and without adjustments were used. The cohort was young (mean age, ≈31 years), with the majority being Blacks (≈70%). The prevalence of a small size apo(a) (≤22 Kringle repeats) or a high Lp(a) level (≥30 mg/dL) was similar by HIV status. Total plasma Lp(a) level (P=0.029) and allele-specific apo(a) level carried by the smaller apo(a) sizes (P=0.022) were significantly associated with carotid artery intima-media thickness in the HIV-infected women only. After accounting for confounders (age, race, smoking, body mass index, blood pressure, hepatitis C virus coinfection, menopause, plasma lipids, treatment status, CD4+ T cell count, and HIV/RNA viral load), the association remained significant for both Lp(a) (P=0.035) and allele-specific apo(a) level carried by the smaller apo(a) sizes (P=0.010) in the HIV-infected women. Notably, none of the other lipids/lipoproteins was associated with carotid artery intima-media thickness. Conclusions - Lp(a) and allele-specific apo(a) levels predict carotid artery intima-media thickness in HIV-infected young women. Further research is needed to identify underlying mechanisms of an increased Lp(a) atherogenicity in HIV infection.

Original languageEnglish (US)
Pages (from-to)997-1004
Number of pages8
JournalArteriosclerosis, thrombosis, and vascular biology
Volume37
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • antiretroviral therapy
  • apo(a) size, HIV treatment
  • apolipoprotein(a)
  • cardiovascular risk
  • carotid artery intima-media thickness
  • lipoprotein(a)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Enkhmaa, B., Anuurad, E., Zhang, W., Li, C. S., Kaplan, R., Lazar, J., Merenstein, D., Karim, R., Aouizerat, B., Cohen, M., Butler, K., Pahwa, S., Ofotokun, I., Adimora, A. A., Golub, E., & Berglund, L. (2017). Lipoprotein(a) and HIV: Allele-specific apolipoprotein(a) levels predict carotid intima-media thickness in hiv-infected young women in the women's interagency HIV study. Arteriosclerosis, thrombosis, and vascular biology, 37(5), 997-1004. https://doi.org/10.1161/ATVBAHA.117.309137