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  51th ICAAC
Chicago, IL
September 17-20, 2011
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Higher Osteoprotegerin Linked to Lower Atherosclerosis Risk in Men With HIV
  51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 17-20, 2011, Chicago

Mark Mascolini

Higher plasma levels of osteoprotegerin, a soluble member of the TNF receptor superfamily that may play roles in bone remodeling and heart disease, correlated with a lower coronary atherosclerosis risk in a study of Italian men with and without HIV infection [1]. Researchers from Sapienza University of Rome hypothesized that osteoprotegerin may be a "biomarker of silent atherosclerosis" in people with HIV.

Osteoprotegerin, also known as osteoclast inhibiting factor and osteoclast binding factor, inhibits differentiation and activation of osteoclasts, which break down bone [2]. Some research links osteoprotegerin levels to cardiovascular disease and suggests osteoprotegerin could serve as a heart disease marker [3-5].

Sapienza University researchers measured osteoprotegerin levels in 39 men with HIV and 21 men without HIV matched to the HIV group by age and traditional cardiovascular risk factors [1]. The HIV-positive men averaged 53 years in age (+/- 9), had taken a protease inhibitor for at least 12 months, had an undetectable viral load, and had a Framingham cardiovascular risk score below 10.

The investigators assessed coronary artery stenosis with 64-slice CT coronary angiography, and they measured carotid intima-media thickness (a marker of cardiovascular disease) with Doppler ultrasound. For men with HIV, the researchers evaluated past and current virologic and immunologic parameters, metabolic criteria, smoking status, and family history of heart disease.

Seventeen men with HIV (44%) had no evidence of coronary artery stenosis, while 22 (56%) had coronary artery disease indicated by greater than 40% stenosis. Osteoprotegerin plasma levels were significantly lower in men with HIV than in HIV-negative controls (5.7 +/- 2.64 versus 8.3 +/- 4.6 pmol/L, P < 0.05). Osteoprotegerin was significantly higher in the HIV-positive men without coronary artery stenosis than in those with stenosis (6.04 +/- 1.77 versus 4.4 +/- 1.71 pmol/L, P = 0.039).

Carotid intima-media thickness was greater in men with HIV than in controls (1.1 +/- 0.25 versus 0.601 +/- 0.04 mm). Plasma levels of osteoprotegerin correlated negatively with carotid intima media thickness--the higher the osteoprotegerin the thinner the carotid intima media--but this correlation stopped short of statistical significance.

Neither osteoprotegerin levels nor coronary artery disease correlated with current CD4 count or viral load.


1. D'Agostino C, D'Abramo A, Iannetta M, et al. Osteoprotegerin as a biomarker of subclinical atherosclerosis in HIV-infected men. 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). September 17-20, 2011. Chicago. Abstract H1-1391.

2. Biomedica. Osteoprotegerin: enzyme immunoassay for the quantitative determination of osteoprotegerin in biological fluids. Cat. No. BI-20402. May 2001. http://www.bionetinc.com/pdf/opginsert.pdf.

3. Poulsen MK, Nybo M, Dahl J, et al. Plasma osteoprotegerin is related to carotid and peripheral arterial disease, but not to myocardial ischemia in type 2 diabetes mellitus. Cardiovasc Diabetol. 2011;10:76. http://www.cardiab.com/content/10/1/76.

4. Venuraju SM, Yerramasu A, Corder R, Lahiri A. Osteoprotegerin as a predictor of coronary artery disease and cardiovascular mortality and morbidity. J Am Coll Cardiol. 2010;55:2049-2061.

5. D'Amelio P, Isaia G, Isaia GC. The osteoprotegerin/RANK/RANKL system: a bone key to vascular disease. J Endocrinol Invest. 2009;32(4 Suppl):6-9.