Abstract
Introduction: Combined antiretroviral therapy (cART) used to treat acquired immunodeficiency virus (HIV) induces a number of adverse effects, such as insulin resistance and dyslipidemia, which ultimately increases the cardiovascular risk. Advanced glycation end products (AGEs) have been implicated in the etiology of cardiovascular diseases, diabetes and other chronic diseases. It is known that physical exercise improves the lipid profile, insulin resistance and reduces the risk of cardiovascular diseases. However, the impact of physical exercise on AGE levels in HIV-infected patients has not been so far investigated. Therefore, this study compared AGEs levels in people with and without HIV and verified the effect of physical training on serum AGE levels.Methods: Participants were initially assigned into three groups: healthy control (CTL, n = 35), physically inactive HIV-infected (In-HIV, n = 33) and physically active HIV-infected (Ac-HIV, n = 19). The In-HIV group underwent physical training for 3 months, consisting of 60-min sessions of multimodal supervised exercise (aerobic, resistance and flexibility) with moderate intensity (50–80% heart rate reserve), performed 3 times/week. AGEs were measured in serum by fluorescence spectrometry.Results: At baseline, serum AGEs fluorescence level was significantly higher in inactive HIV-patients when compared to controls or active HIV-patients (In-HIV: 0.93 ± 0.08 vs. controls: 0.68 ± 0.13 and Ac-HIV: 0.59 ± 0.04 A.U.; P < 0.001). Triglycerides were also higher in In-HIV than CTL (182.8 ± 102 vs. 132.8 ± 52.3 mg/dL; P < 0.05). Waist circumference was lower in Ac-HIV, compared to In-HIV and controls (83.9 ± 10.4 vs. 92.9 ± 13.5 and 98.3 ± 12.4, respectively; P < 0.05). Body mass, fasting blood glucose, LDL, HDL, and total cholesterol were similar between groups. After training, AGE levels decreased (Baseline: 0.93 ± 0.08 vs. 3 months follow-up: 0.59 ± 0.04 AU; P < 0.001), no further difference being detected vs. CTL or Ac-HIV. Conclusion: HIV-infected patients under cART exhibited elevated AGEs levels compared to healthy individuals and physically active patients. Short-term aerobic training of moderate intensity counteracted this condition.
Highlights
Combined antiretroviral therapy used to treat acquired immunodeficiency virus (HIV) induces a number of adverse effects, such as insulin resistance and dyslipidemia, which increases the cardiovascular risk
The binding of Advanced glycation end products (AGEs) to their receptor for advanced glycation end products (RAGE) receptor promotes the activation of proinflammatory and procoagulant cellular pathways that increases the production of adhesion molecules, cytokines such as interleukin 6 (IL-6) and TNFα, and decreases the bioavailability of nitric oxide (NO) (Goldin et al, 2006)
Body mass index was lower in Ac-HIV patients (P < 0.01) and triglycerides were higher in into a physically inactive group (In-HIV) patients (P < 0.05) compared to controls, while waist circumference were lower in Ac-HIV compared to In-HIV patients and controls (Table 1)
Summary
Combined antiretroviral therapy (cART) used to treat acquired immunodeficiency virus (HIV) induces a number of adverse effects, such as insulin resistance and dyslipidemia, which increases the cardiovascular risk. Advanced glycation end products are proteins or lipids that become glycated as a result of exposure to reduced sugars (Singh et al, 2001). These products may increase the risk of development, or worsening, of a number of degenerative diseases, such as diabetes, CVD, chronic kidney and liver diseases, and neurodegenerative syndromes, such as Alzheimer disease (Genuth et al, 2005; Hyogo et al, 2007; Kerkeni et al, 2014; Silvares et al, 2016; Pereira et al, 2017). The binding of AGEs to their RAGE receptor promotes the activation of proinflammatory and procoagulant cellular pathways that increases the production of adhesion molecules, cytokines such as IL-6 and TNFα, and decreases the bioavailability of NO (Goldin et al, 2006)
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