Prevalence and Determinants of Endothelial Dysfunction among Adults Living with HIV in Northwest Nigeria

Aisha M. Nalado; Bala Waziri; Anas Ismail; Nafiu Umar; Zainab U. Ibrahim; Patience Obiagwu; Baba M. Musa; Mahmoud U. Sani; Aliyu Abdu; Faisal S. Dankishiya; Mansur A. Ramalan; Hadiza Saidu; Usman J. Wudil; C. William Wester; Muktar H. Aliyu

doi:10.5334/gh.1264

Prevalence and Determinants of Endothelial Dysfunction among Adults Living with HIV in Northwest Nigeria

Volume 18 (2023): Issue 1

By: Aisha M. Nalado, Bala Waziri, Anas Ismail , Nafiu Umar, Zainab U. Ibrahim, Patience Obiagwu , Baba M. Musa, Mahmoud U. Sani , Aliyu Abdu , Faisal S. Dankishiya, Mansur A. Ramalan, Hadiza Saidu, Usman J. Wudil, C. William Wester and Muktar H. Aliyu

Open Access

|Oct 2023

Figures & Tables

Table 1

Baseline characteristics of participants by HIV status, Kano, Nigeria.

COVARIATE	ALL PARTICIPANTS (n =400)	HIV POSITIVE (n = 200)	HIV NEGATIVE (n = 200)	p-VALUE
Age (years)	42 ± 11	46 ± 10	38 ± 11	< 0.0001
Sex n (%)
Male	210 (52.5)	102 (51.0)	108 (54.0)
Female	190 (47.5)	98 (49.0)	92 (46.0)	0.62
BMI	24.0 ± 4.6	23.9 ± 5.3	24.0 ± 3.8	0.80
Systolic BP (mm Hg)	114 ± 18	114 ± 22	112 ± 12	0.16
Diastolic BP (mm Hg)	75 ± 12	77 ± 15	74 ± 9	0.049
Total cholesterol (mmol/L)	4.85 ± 1.02	4.85 ± 1.18	4.85 ± 0.84	0.98
HDL-C (mmol/L)	0.88 (0.58–1.23)	0.73 (0.44–1.27)	0.94 (0.7–1.21)	0.003
LDL-C (mmol/L)	3.31 ± 0.94	3.32 ± 1.04	3.29 ± 0.82	0.69
Total cholesterol categories
Desirable (<5.2 mmol/L)	262 (65.5)	125 (62.5)	137 (68.5)	0.08
Borderline high (5.2–6.1 mmol/L)	94 (65.5)	46 (23.0)	48 (24.0)
High(>6.1 mmol/L)	44 (23.5)	29 (14.5)	15 (7.5)
Optimal LDL (<2.6 mmol/L)	81 (20.2)	46 (23.0)	35 (17.5)	0.17
Best HDL	42 (10.5)	23 (11.5)	19 (9.5)	0.52
Ever smoked, n (%)	10 (2.5)	10 (5.5)	0 (0.0)
HTN n (%)	43 (10.7)	43 (21.5)	0 (0.0)
Diabetes mellitus n (%)	10 (2.5)	10 (5.0)	0 (0.0)
Cystatin C	0.90 ± 0.36	1.00 ± 0.43	0.79 ± 0.23	< 0.0001
uACR	25.9 (10.5–54.9)	41.6 (23.2–162.9)	14.5 (7.4–27.0)	< 0.0001
ACR categories, n (%)
Normoalbuminuria	225 (56.3)	71 (35.5)	154 (77.0)	< 0.001
Microalbuminuria	136 (34.0)	90 (45.0)	46 (23.0)	< 0.001
Macroalbuminuria	39 (9.8)	39 (19.5)	0 (0.0)
Albuminuria (uACR ≥ 30 mg/g), n (%)	175 (43.8)	129 (64.5)	46 (23.0)	< 0.001
eGFR (ml/min/1.73m²)	110.9 ± 30.6	99.2 ± 29.1	122.6 ± 27.5	< 0.0001
eGFR (<60ml/min), n (%)	21 (5.3)	19 (9.5)	2 (1.0)	< 0.001
cIMT = carotid artery intima media thickness	0.71 ± 0.34	0.74 ± 0.45	0.68 ± 0.15	0.08
AFMD	10.96 ± 7.65	9.82 ± 5.43	12.09 ± 9.23	0.003
HIV RNA, log copies/mL	–	3.31 ± 1.10	–
HIV-1 RNA (viral load) suppressed, n (%)	–	193 (96.5)	–	–
CD4+ cell count, cells/mm³	–	433 (298–592)	–	–

[i] uACR = urine albumin-to-creatinine ratio, FMD = brachial artery flow-mediated dilation, cIMT = carotid artery intima media thickness, HDL = high-density lipoprotein cholesterol, LDL = low-density lipoprotein cholesterol, eGFR = estimated glomerular filtration rate.

Table 2

Factors associated with brachial artery flow-mediated dilation, Kano, Nigeria.

VARIABLE	UNADJUSTED MODEL				ADJUSTED MODEL
VARIABLE	β-COEFFICIENT	SE	95% CI	p-VALUE	β-COEFFICIENT	SE	95% CI	p-VALUE
HIV positive	–2.28	0.76	–3.77, –0.79	0.003	–2.83	0.82	–4.44, –1.21	0.001
Age (years)	–0.03	0.03	–0.09, 0.04	0.45	–0.04	0.04	–0.121, 0.03	0.27
Diastolic BP (mm Hg)	–0.02	0.03	–0.08, 0.04	0.48	–0.05	0.03	–0.11, 0.02	0.14
eGFR (ml/min/1.73 m²)	–0.02	0.01	–0.04, 0.01	0.13	–0.04	0.02	–0.07, –0.01	0.004
Total cholesterol (mmol/L)	0.71	0.37	–0.02, 1.44	0.057	1.34	0.48	0.41, 2.28	0.005
LDL cholesterol (mmol/L)	–0.32	0.41	–1.12, 0.48	0.43	–1.12	0.51	–2.13, –0.11	0.029

[i] BP = blood pressure, CI = confidence interval, LDL = low-density lipoprotein, SE = standard error, eGFR = estimated glomerular filtration.

Table 3

Factors associated with common carotid intima-media thickness, Kano, Nigeria.

VARIABLE	UNADJUSTED MODEL				ADJUSTED MODEL
VARIABLE	β-COEFFICIENT	SE	95% CI	p-VALUE	β-COEFFICIENT	SE	95% CI	p-VALUE
HIV positive	0.046	0.025	–0.002, 0.095	0.059	–0.003	0.027	–0.056, 0.050	0.901
Age (years)	0.008	0.001	0.0058, 0.0099	< 0.001	0.008	0.001	0.0055, 0.010	< 0.001
Systolic BP (mm Hg)	0.003	0.001	0.0011, 0.0038	< 0.001	0.002	0.001	0.0002, 0.0029	0.024
Total cholesterol (mmol/L)	0.002	0.012	–0.022, 0.0255	0.90	–0.013	0.015	–0.0429, 0.0153	0.351
LDL cholesterol (mmol/L)	–0.006	0.013	–0.0320, 0.0199	0.65	–0.005	0.016	–0.0356, 0.0153	0.757
Albuminuria (uACR > 30 mg/g)	0.015	0.025	–0.0344, 0.0637	0.56	–0.011	0.026	–0.061, 0.0396	0.666
Diabetes mellitus	0.019	0.079	–0.1367, 0.1751	0.81	0.102	0.075	–0.0459, 0.250	0.176

[i] Dependent variable is log-10 cIMT, BP = blood pressure, LDL = low-density lipoprotein, SE = standard error, uACR=urine albumin-to-creatinine ratio.

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DOI: https://doi.org/10.5334/gh.1264 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Feb 6, 2023

Accepted on: Aug 22, 2023

Published on: Oct 20, 2023

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

endothelial dysfunction,

cardiovascular disease,

HIV,

microalbuminuria

© 2023 Aisha M. Nalado, Bala Waziri, Anas Ismail, Nafiu Umar, Zainab U. Ibrahim, Patience Obiagwu, Baba M. Musa, Mahmoud U. Sani, Aliyu Abdu, Faisal S. Dankishiya, Mansur A. Ramalan, Hadiza Saidu, Usman J. Wudil, C. William Wester, Muktar H. Aliyu, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 18 (2023): Issue 1