2138. Elevations of Short Chain Dicarboxylacylcarnitine (SCDA) Levels Precede Major Cardiovascular Events in HIV-Infected Persons
Session: Poster Abstract Session: HIV Cardiovascular Disease, Lipids, and Diabetes
Saturday, October 29, 2016
Room: Poster Hall
  • IDSA Poster 2016 Okeke Metabolomics_Final.pdf (153.0 kB)
  • Background: HIV-infected persons are at increased risk for major cardiovascular disease (CVD) events compared to uninfected persons. The excess risk of CVD events in HIV-infected persons cannot be explained by traditional risk factors alone. Biomarkers to assist in CVD risk stratification in HIV-infected persons are lacking. Short chain dicarboxylacylcarnitines (SCDA), a mitochondrial metabolite shown to predict CVD events in uninfected persons, have never been studied in persons with HIV.

    Methods: We conducted a targeted metabolomics analysis of plasma samples from 24 pairs of virally suppressed HIV-infected persons from the Duke HIV CVD Cohort, in a case-control format. Cases were defined as HIV-infected persons with documentation of acute myocardial infarction or diagnosis of severe coronary artery disease (CAD) by cardiac catheterization. HIV-infected cases without a history of CAD were matched 1:1 by age, race, sex, mean SBP and CD4 count. Only samples that preceded CAD diagnosis were included. Tandem flow injection mass spectrometry was used to quantify levels of a validated targeted metabolite panel (N=63). To reduce data complexity, we consolidated metabolites with collinear measures into interpretable factors using principal component analysis (PCA). Comparison of factor levels between cases and controls was done by student’s T-test.


    48 HIV-infected persons were included in the analysis. Patient characteristics were: mean age 52.4 ± 8.1; 50% Black, 79% male; mean systolic BP 138mm Hg; mean BMI: 26.5kg/m2 for cases and 26.8 kg/m2 for controls; mean most recent CD4 573 cells/mm3 for cases, 476 cells/mm3 for controls. Based on metabolite levels, 14 factors were derived. The SCDA-derived factor (Ci4-DC/C4-DC, C5-DC, C6-DC, C10-OH/C8-DC, C12-OH/C10-DC, C6:1-DC/C8:1-OH, C8:1-DC acylcarnitines] was one of only two factors that revealed markedly higher plasma levels in cases than controls (p = 0.06).

    Conclusion: HIV-infected persons with known major CAD events have significantly higher circulating levels of SCDA prior to their event than HIV-infected persons without known CAD. Although larger studies are ongoing for validation, SCDA may be an important biomarker in optimizing CVD risk stratification for HIV-infected persons.

    Nwora Lance Okeke, MD1, Susanna Naggie, MD, MHS2, Damian Craig, Ph.D3, Michael Muehlbauer, Ph.D4, Olga Ilkayeva, Ph.D4 and Svati Shah, MD4,5, (1)Medicine -Infectious Diseases, Duke University Medical Center, Durham, NC, (2)Infectious Diseases Research, Duke Clinical Research Institute, Durham, NC, (3)Duke Molecular physiology Institute, Durham, NC, (4)Duke Molecular Physiology Institute, Durham, NC, (5)Medicine-Cardiology, Duke University Medical Center, Durham, NC


    N. L. Okeke, None

    S. Naggie, None

    D. Craig, None

    M. Muehlbauer, None

    O. Ilkayeva, None

    S. Shah, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.