HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer

Barbara S. Taylor, Kaku So-Armah, Janet P. Tate, Vincent C. Marconi, John R. Koethe, Roger J. Bedimo, Adeel A. Butt, Cynthia L. Gibert, Matthew B. Goetz, Maria C. Rodriguez-Barradas, Julie A. Womack, Mariana Gerschenson, Vincent Lo Re, David Rimland, Michael T. Yin, David Leaf, Russell P. Tracy, Amy C. Justice, Matthew S. Freiberg

Research output: Contribution to journalArticle

Abstract

Objectives: Obesity prevalence among people living with HIV (HIV+) is rising. HIV and obesity are proinflammatory states, but their combined effect on inflammation (measured by interleukin 6, IL-6), altered coagulation (D-dimer), and monocyte activation (soluble CD14, sCD14) is unknown. We hypothesized inflammation increases when obesity and HIV infection co-occur. Methods: The Veterans Aging Cohort Study survey cohort is a prospective, observational study of predominantly male HIV+ veterans and veterans uninfected with HIV; a subset provided blood samples. Inclusion criteria for this analysis were body mass index ≥ 18.5 kg/m2 and biomarker measurement. Dependent variables were IL-6, sCD14, and D-dimer quartiles. Obesity/HIV status was the primary predictor. Unadjusted and adjusted logistic regression models were constructed. Results: Data were analyzed for 1477 HIV+ and 823 uninfected participants. Unadjusted median IL-6 levels were significantly higher and sCD14 levels significantly lower in obese/HIV+ compared with nonobese/uninfected (P <0.01 for both). In adjusted analyses, the odds ratio for increased IL-6 in obese/HIV+ patients was 1.76 (95% confidence interval: 1.18 to 2.47) compared with nonobese/uninfected, and obesity/HIV+ remained associated with lower odds of elevated sCD14. We did not detect a synergistic association of co-occurring HIV and obesity on IL-6 or sCD14 elevation. D-dimer levels did not differ significantly between body mass index/HIV status groups. Conclusions: HIV-obesity comorbidity is associated with elevated IL-6, decreases in sCD14, and no significant difference in D-dimer. These findings are clinically significant, as previous studies associated these biomarkers with mortality. Future studies should assess whether other biomarkers show similar trends and potential mechanisms for unanticipated sCD14 and D-dimer findings.

Original languageEnglish (US)
Pages (from-to)500-508
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume75
Issue number5
DOIs
StatePublished - Aug 15 2017

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Comorbidity
Interleukin-6
Obesity
HIV
Veterans
Biomarkers
fibrin fragment D
Body Mass Index
Logistic Models
Inflammation
HIV Infections
Observational Studies
Monocytes
Cohort Studies
Odds Ratio
Prospective Studies
Confidence Intervals
Mortality

Keywords

  • coagulation
  • HIV
  • inflammation
  • monocyte activation
  • obesity
  • VACS

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer. / Taylor, Barbara S.; So-Armah, Kaku; Tate, Janet P.; Marconi, Vincent C.; Koethe, John R.; Bedimo, Roger J.; Butt, Adeel A.; Gibert, Cynthia L.; Goetz, Matthew B.; Rodriguez-Barradas, Maria C.; Womack, Julie A.; Gerschenson, Mariana; Lo Re, Vincent; Rimland, David; Yin, Michael T.; Leaf, David; Tracy, Russell P.; Justice, Amy C.; Freiberg, Matthew S.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 75, No. 5, 15.08.2017, p. 500-508.

Research output: Contribution to journalArticle

Taylor, BS, So-Armah, K, Tate, JP, Marconi, VC, Koethe, JR, Bedimo, RJ, Butt, AA, Gibert, CL, Goetz, MB, Rodriguez-Barradas, MC, Womack, JA, Gerschenson, M, Lo Re, V, Rimland, D, Yin, MT, Leaf, D, Tracy, RP, Justice, AC & Freiberg, MS 2017, 'HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer', Journal of Acquired Immune Deficiency Syndromes, vol. 75, no. 5, pp. 500-508. https://doi.org/10.1097/QAI.0000000000001444
Taylor, Barbara S. ; So-Armah, Kaku ; Tate, Janet P. ; Marconi, Vincent C. ; Koethe, John R. ; Bedimo, Roger J. ; Butt, Adeel A. ; Gibert, Cynthia L. ; Goetz, Matthew B. ; Rodriguez-Barradas, Maria C. ; Womack, Julie A. ; Gerschenson, Mariana ; Lo Re, Vincent ; Rimland, David ; Yin, Michael T. ; Leaf, David ; Tracy, Russell P. ; Justice, Amy C. ; Freiberg, Matthew S. / HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer. In: Journal of Acquired Immune Deficiency Syndromes. 2017 ; Vol. 75, No. 5. pp. 500-508.
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T1 - HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer

AU - Taylor, Barbara S.

AU - So-Armah, Kaku

AU - Tate, Janet P.

AU - Marconi, Vincent C.

AU - Koethe, John R.

AU - Bedimo, Roger J.

AU - Butt, Adeel A.

AU - Gibert, Cynthia L.

AU - Goetz, Matthew B.

AU - Rodriguez-Barradas, Maria C.

AU - Womack, Julie A.

AU - Gerschenson, Mariana

AU - Lo Re, Vincent

AU - Rimland, David

AU - Yin, Michael T.

AU - Leaf, David

AU - Tracy, Russell P.

AU - Justice, Amy C.

AU - Freiberg, Matthew S.

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N2 - Objectives: Obesity prevalence among people living with HIV (HIV+) is rising. HIV and obesity are proinflammatory states, but their combined effect on inflammation (measured by interleukin 6, IL-6), altered coagulation (D-dimer), and monocyte activation (soluble CD14, sCD14) is unknown. We hypothesized inflammation increases when obesity and HIV infection co-occur. Methods: The Veterans Aging Cohort Study survey cohort is a prospective, observational study of predominantly male HIV+ veterans and veterans uninfected with HIV; a subset provided blood samples. Inclusion criteria for this analysis were body mass index ≥ 18.5 kg/m2 and biomarker measurement. Dependent variables were IL-6, sCD14, and D-dimer quartiles. Obesity/HIV status was the primary predictor. Unadjusted and adjusted logistic regression models were constructed. Results: Data were analyzed for 1477 HIV+ and 823 uninfected participants. Unadjusted median IL-6 levels were significantly higher and sCD14 levels significantly lower in obese/HIV+ compared with nonobese/uninfected (P <0.01 for both). In adjusted analyses, the odds ratio for increased IL-6 in obese/HIV+ patients was 1.76 (95% confidence interval: 1.18 to 2.47) compared with nonobese/uninfected, and obesity/HIV+ remained associated with lower odds of elevated sCD14. We did not detect a synergistic association of co-occurring HIV and obesity on IL-6 or sCD14 elevation. D-dimer levels did not differ significantly between body mass index/HIV status groups. Conclusions: HIV-obesity comorbidity is associated with elevated IL-6, decreases in sCD14, and no significant difference in D-dimer. These findings are clinically significant, as previous studies associated these biomarkers with mortality. Future studies should assess whether other biomarkers show similar trends and potential mechanisms for unanticipated sCD14 and D-dimer findings.

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