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Receptor Activator of Nuclear Factor-κB Ligand (RANKL) and Its Relationship to Coronary Atherosclerosis in HIV Patients

Hwang, Janice J. MD*; Wei, Jeffrey BA*; Abbara, Suhny MD; Grinspoon, Steven K. MD*; Lo, Janet MD, MMSc*

JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2012 - Volume 61 - Issue 3 - p 359–363
doi: 10.1097/QAI.0b013e31826a6c16
Brief Report: Clinical Science

Abstract: HIV-infected individuals have an increased prevalence of coronary artery disease. Receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin have been postulated as mediators of vascular calcification. 78 HIV-infected men and 32 healthy controls without history of coronary artery disease were prospectively recruited to undergo cardiac computed tomography and computed tomography angiography to assess coronary artery calcium and plaque burden. Soluble receptor activator of nuclear factor-κB ligand was lower in HIV-infected individuals than controls [2.52 (1.08–3.98) vs. 3.33 (2.44–4.64) pg/mL, P = 0.01, median (IQR) respectively]. Soluble receptor activator of nuclear factor-κB ligand was negatively associated with the number of coronary segments with plaque (Spearman ρ = −0.41, P < 0.001) and Agatston calcium score (ρ = −0.30, P < 0.01) in HIV-infected individuals even after adjusting for traditional cardiovascular risk factors.

*Program in Nutritional Metabolism, Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA

Department of Radiology, Cardiovascular Imaging Section, Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Correspondence to: Janet Lo, MD, MMSc, Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit Street, LON207, Boston, MA 02114 (e-mail:

Funding was received from NIH T32 DK007028-37 (Dr J.J.H.), K23 HL092792 (Dr J.L.), K24 DK064545 (Dr. S.K.G.), F32 HL088991 (Dr J.L.), M01 RR01066-25S1, and Bristol Myers Squibb, Inc., Funding sources had no role in the design of the study, data analysis or the writing of the article.

Dr S.K.G. received research funding for this investigator-initiated research project through Bristol Myers Squibb, Inc.

Principal contributions of authors are: study conception (J.J.H., J.L., S.K.G.), study design (J.J.H., J.L., S.K.G.), statistical analysis and interpretation (J.J.H., J.L., S.K.G.), drafting of the article (J.J.H., J.L., S.K.G.), critical revision of aricle (J.H., J.L., S.A., J.W., S.K.G.), and supervision of study (J.L., S.K.G.).

Clinical Trial Registration Number: NCT 00455793.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (

Received May 01, 2012

Accepted July 18, 2012

© 2012 Lippincott Williams & Wilkins, Inc.