Browsing by Author "Glesby, Marshall J."

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    Elevated cardiac risk score by Atherosclerotic Cardiovascular Disease calculation is associated with albuminuria in older people living with HIV
    (Wolters Kluwer, 2020-05-01) Johnston, Carrie D.; Ifeagwu, Kene-Chukwu C.; Siegler, Eugenia L.; Derry, Heather; Burchett, Chelsie O.; Rice, Michelle C.; Gupta, Samir K.; Choi, Mary E.; Glesby, Marshall J.; Medicine, School of Medicine
    Globally, the proportion of older people living with HIV (PLWH) is growing and the burden of non-communicable diseases, including cardiac and renal disease, is increasing. There are few studies of renal disease and cardiac risk in older PLWH. This study investigates the relationship between albuminuria and cardiac risk as estimated by the ASCVD 10-year risk calculator. We report that albuminuria is associated with a higher ASCVD risk score in both diabetic and non-diabetic older PLWH.
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    Urine Cell-Free Mitochondrial DNA as a Marker of Weight Loss and Body Composition in Older Adults with HIV
    (Wolters Kluwer, 2021) Johnston, Carrie D.; Siegler, Eugenia L.; Rice, Michelle C.; Derry, Heather M.; Hootman, Katie C.; Zhu, Yuan-Shan; Burchett, Chelsie O.; Gupta, Samir K.; Choi, Mary E.; Glesby, Marshall J.; Medicine, School of Medicine
    Background: Older adults with HIV (OAH) experience more comorbidities and geriatric syndromes than their HIV-negative peers, perhaps because of chronic inflammation. Cell-free mitochondrial DNA (cfmtDNA) released from cells undergoing necrosis-mediated cell death potentially acts as both a mediator and marker of inflammatory dysregulation. We hypothesized that urinary cfmtDNA would be associated with frailty, body composition, and fall history in OAH. Methods: OAH completed frailty testing, a psychosocial survey, body composition assessment, and measurement of urine cfmtDNA and urine albumin:creatinine in this cross-sectional study. Urine cfmtDNA was measured by quantative polymerase chain reaction and normalized to urinary creatinine. Results: Across 150 participants, the mean age was 61 years (SD 6 years), half identified as Black, one-third were women, and 93% had HIV-1 viral load <200 copies/mL. Two-thirds met criteria for a prefrail or frail state. Those with unintentional weight loss had higher urine cfmtDNA concentrations (P = 0.03). Higher urine cfmtDNA was inversely associated with the skeletal muscle index (β = -0.19, P < 0.01) and fat mass index (β = -0.08, P = 0.02) in separate multiple linear regression models adjusted for age, sex, and presence of moderate-severe albuminuria. Conclusions: In this cross-sectional study of OAH, higher levels of urine cfmtDNA were more common in subjects with less robust physical condition, including unintentional weight loss and less height-scaled body mass of fat and muscle. These findings suggest urine cfmtDNA may reflect pathophysiologic aging processes in OAH, predisposing them to geriatric syndromes. Longitudinal investigation of urine cfmtDNA as a biomarker of geriatric syndromes is warranted.