(P29-005-23) Food Insecurity Is Associated With High CRP and sCD14 in the Miami Adult Studies on HIV (MASH) Cohort

Objectives: Food insecurity has been associated with elevated inflammatory markers leading to higher rates of mortality in the general population. However, data on food security (FS) and inflammatory markers like high sensitivity C-Reactive Protein (hs-CRP) and soluble CD14 (sCD14) in a minority, marginalized population living with and without HIV is yet to be explored. In this study, we evaluated the association between FS and high levels of inflammation in people living with and without HIV.

Methods: A cross-sectional analysis of 1034 participants from the MASH cohort was performed. Demographics, anthropometrics, and blood samples were collected by trained personnel. HIV viral loads (VL, copies/ml) were obtained from medical records (suppressed VL ≤ 50 copies/ml). FS status was assessed using the USDA Household Food Security Module and analyzed as food secure (score 0), marginal (score 1), low (score 2-4), and very low (score 5-6) FS. Hs-CRP was analyzed by LabCorp and high hs-CRP was defined as ≥ 10 mg/L. sCD14 levels were determined with a bead-based Luminex immunoassay. Multinomial logistic regression and linear regression models were adjusted for age, sex, race, ethnicity, and HIV status using SPSS 26.

Results: Nearly half of the participants were food insecure (48.4 %), 46.6% were people living with HIV and 90.9% had a suppressed VL. The mean age was 54.6 ± 7.9 years, 58% were male, and 61.1% non-Hispanic Black. Mean hs-CRP and sCD14 levels were 4.78 ± 8.68 mg/L and 1274.40 ± 452.75 ng/mL, respectively. A Chi-square test revealed no significant difference (p >0.05) between BMI (kg/m2) and FS status. In the adjusted logistical models, participants who had very low FS had greater odds of having high hs-CRP levels compared to those who had low and marginal FS (OR=2.40, 95% CI: 1.18-4.57, P=0.016; OR=2.29 95% CI: 1.14-4.58; P=0.020, respectively). There was also a statistically significant linear association between FS status and sCD14 levels (adj β: 30.94 SE:13.19; p=0.019).

Conclusions: Food insecurity, but not HIV infection, was associated with an increased risk of elevated inflammatory markers in a minority marginalized population with and without HIV. These findings show the need for programs addressing food insecurity to lower systemic inflammation and improve long-term health, especially in underserved minorities.

Funding Sources: NIH/NIDA grant #U01DA040381