研究表明，人类免疫缺陷病毒（HIV）人群冠状动脉疾病（CAD）的风险增加。心外膜脂肪（EF）质量可能与这种风险增加有关。在我们的研究中，我们评估了EF密度（脂肪的定性特征）、炎症标志物、心血管风险因素、HIV相关参数和CAD之间的关联。我们的研究是横断面研究，嵌套在加拿大HIV与衰老队列研究中，该研究是一个包括HIV感染者和健康对照组的大型前瞻性队列研究。参与者接受心脏计算机断层扫描血管造影以测量EF体积和密度、冠状动脉钙化评分、冠状动脉斑块和低密度斑块体积。使用调整回归分析评估EF密度、心血管风险因素、HIV参数和CAD之间的关联。本研究共纳入了177名HIV感染者和83名健康对照组。EF密度在两组之间相似（HIV感染者为-77.4±5.6 HU，未感染控制组为-77.0±5.6 HU，P=.162）。多变量模型显示，EF密度与冠状动脉钙化评分呈正相关（比值比为1.07，P=.023）。在本研究中测量的可溶性生物标志物中，调整分析显示，IL2Rα、肿瘤坏死因子α和黄体生成素与EF密度显著相关。我们的研究表明，在包括HIV感染者的人群中，EF密度的增加与较高的冠状动脉钙化评分和炎症标志物相关。版权所有©2023作者。出版由沃尔特斯• 克鲁尔卫生公司。

Studies have shown an increased risk of coronary artery disease (CAD) in the human immunodeficiency virus (HIV) population. Epicardial fat (EF) quality may be linked to this increased risk. In our study, we evaluated the associations between EF density, a qualitative characteristic of fat, and inflammatory markers, cardiovascular risk factors, HIV-related parameters, and CAD. Our study was cross-sectional, nested in the Canadian HIV and Aging Cohort Study, a large prospective cohort that includes participants living with HIV (PLHIV) and healthy controls. Participants underwent cardiac computed tomography angiography to measure volume and density of EF, coronary artery calcium score, coronary plaque, and low attenuation plaque volume. Association between EF density, cardiovascular risk factors, HIV parameters, and CAD were evaluated using adjusted regression analysis. A total of 177 PLHIV and 83 healthy controls were included in this study. EF density was similar between the two groups (-77.4 ± 5.6 HU for PLHIV and -77.0 ± 5.6 HU for uninfected controls, P = .162). Multivariable models showed positive association between EF density and coronary calcium score (odds ratio, 1.07, P = .023). Among the soluble biomarkers measured in our study, adjusted analyses showed that IL2Rα, tumor necrosis factor alpha and luteizing hormone were significantly associated with EF density. Our study showed that an increase in EF density was associated with a higher coronary calcium score and with inflammatory markers in a population that includes PLHIV.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.