Atherosclerotic Risk and Response to Exercise Intervention in HIV+ Children

HIV儿童的动脉粥样硬化风险和运动干预的反应

• 批准号: 7691244
• 负责人: TRACIE L MILLER
• 金额: $ 38.25万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-25 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7691244
• 关键词: Adult; Adverse effects; Aerobic; Aerobic Exercise; Age; Anti-Retroviral Agents; Atherosclerosis; Attention; Biological Markers; Blood Platelets; Blood Vessels; Body Composition; Body fat; Body mass index; CCL2 gene; Cardiac; Cardiovascular system; Child; Childhood; Chronic; Chronic Disease; Clinical; Coagulants; Cross-Sectional Studies; Data; Developed Countries; Developing Countries; Disease; E-Selectin; Equilibrium; Exercise; Exposure to; Fasting; Fatty acid glycerol esters; Fibrinogen; Functional disorder; Glucose; Goals; HIV; HIV Infections; Habits; Highly Active Antiretroviral Therapy; Home environment; Hyperlipidemia; Immune; Individual; Inflammation; Inflammatory; Insulin; Insulin Resistance; Intercellular adhesion molecule 1; Interleukin-6; Intervention; Lead; Length; Leptin; Leukocytes; Life; Life Style; Lipids; Measures; Medial; Mediating; Metabolic; Metabolic syndrome; Morbidity - disease rate; Myocardial; Nutritional; Obesity; Outcome; Oxygen; Oxygen Consumption; Pathway interactions; Pharmaceutical Preparations; Plasminogen Activator Inhibitor 1; Prevalence; Protease Inhibitor; Quality of life; Randomized Controlled Clinical Trials; Recruitment Activity; Research Design; Resistance; Risk; Risk Factors; Sampling; Serum; Severity of illness; Siblings; Smoke; Structure; Terminology; Thick; Time; Training Programs; Vascular Cell Adhesion Molecule-1; Vasodilation; Viral; Visceral; Visit; Weight; abstracting; adiponectin; base; cardiovascular risk factor; childhood cancer survivor; growth promoting activity; improved; mortality; premature; programs; response; sex; survivorship; uptake; vascular endothelial dysfunction

DESCRIPTION (provided by applicant): With greater use of highly active antiretroviral therapy (HAART) in HIV-infected children, adverse metabolic abnormalities have increased both in prevalence and scope. Evidence suggests that adults with HIV infection are at an increased risk of developing premature atherosclerotic CV disease associated with abnormal metabolic profiles. However, far less is known about CV risk in children with HIV. Ongoing chronic inflammation that results from chronic immune activation in HIV-infected individuals may impair vascular endothelial function and further increase the risk of CV disease. Data regarding metabolic syndrome and vascular endothelial dysfunction in HIV-infected children is limited. Therefore, we are proposing a study to understand the extent of vascular dysfunction and identify potential HIV-specific risk factors. We also propose an intervention to treat adverse CV risk factors (endothelial dysfunction, adverse metabolic profiles) and improve clinical outcomes such as quality of life). In Specific Aim 1, we will prospectively recruit 100 HIV- infected children and 100 of their siblings into a cross-sectional study evaluating vascular inflammatory pathways (biomarkers of inflammation, endothelial dysfunction, pro-coagulants and metabolic dysfunction) and vascular dysfunction (through flow-mediated vasodilation studies [FMD] and carotid intimal medial thickness) and will correlate levels with body composition (fat redistribution), lipids and insulin resistance (HOMA-IR scores). In Specific Aim 2, we will determine the effect of a 12-week (2 visits per week) combined resistance and aerobic exercise intervention on nutritional, CV, and clinical outcomes for HIV-infected children. HIV- infected children (from Aim 1) will be equally divided into an active exercise intervention (40) and attention control (40) groups [goal is 25 per group]. This group will be offered the intervention after 3 months. Baseline studies of maximal myocardial oxygen uptake, vascular endothelial dysfunction (studies reviewed above), body composition, lipids, insulin resistance, quality of life and compliance will be compared at baseline, 3 months (at the end of the intervention), and 6 months (3 months after the intervention is completed). Through this study we will determine the extent of vascular dysfunction and its associations with metabolic parameters and will determine whether a structured exercise program positively changes these abnormalities in HIV-infected children. (End of Abstract)

描述（由申请人提供）： 通过在HIV感染的儿童中更多地使用高度活性的抗逆转录病毒疗法（HAART），不良代谢异常在患病率和范围上都增加了。有证据表明，患有HIV感染的成年人有增加与异常代谢谱相关的早产性动脉粥样硬化CV疾病的风险。但是，关于艾滋病毒儿童的简历风险知之甚少。受HIV感染者慢性免疫激活引起的持续慢性炎症可能会损害血管内皮功能，并进一步增加CV疾病的风险。有关HIV感染儿童中代谢综合征和血管内皮功能障碍的数据是有限的。因此，我们提出一项研究，以了解血管功能障碍的程度并确定潜在的HIV特异性危险因素。我们还提出了一项干预措施，以治疗不良的简历危险因素（内皮功能障碍，不良代谢概况）并改善临床结果，例如生活质量）。在特定目标1中，我们将前瞻性地招募100名受HIV感染的儿童及其100个兄弟姐妹，以评估血管炎症途径（炎症的生物标志物，内皮功能障碍，促凝和代谢功能障碍）和血管界功能障碍（通过流动型厚度及其流动性依次Infmd Infmd Inimimatim and Infmd Inimimatimed）[FMD）[FMD）[并将与身体成分（脂肪再分配），脂质和胰岛素抵抗（HOMA-IR评分）相关。在特定的目标2中，我们将确定对HIV感染的儿童的营养，简历和临床结局的12周（每周2次访问）（每周2次访问）（每周2次访问）的影响。艾滋病毒感染的儿童（来自目标1）将同样分为主动运动干预（40）和注意力控制（40）组[目标为25个]。该小组将在三个月后提供干预措施。对最大心肌氧摄取，血管内皮功能障碍（上述研究），身体成分，脂质，胰岛素抵抗，生活质量和依从性的基线研究将在基线时进行3个月（干预结束时）和6个月（干预后3个月）进行比较。 通过这项研究，我们将确定血管功能障碍的程度及其与代谢参数的关联，并将确定结构化的运动计划是否积极地改变了感染HIV感染的儿童的这些异常。 （抽象的结尾）