Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 11;18(1):32.
doi: 10.1186/s12879-017-2884-9.

Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study

Maria Teresa Beires  1 , André Silva-Pinto  2   3 , Ana Cristina Santos  4   5 , António José Madureira  6 , Jorge Pereira  7 , Davide Carvalho  8 , António Sarmento  2   3 , Paula Freitas  8
Affiliations

Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study

Maria Teresa Beires et al. BMC Infect Dis. .

Abstract

Background: Combined antiretroviral therapy (cART) in HIV-infected patients has been associated with lipodystrophy, metabolic abnormalities, and an increased risk of cardiovascular disease. Ultrasound measures of carotid artery intima-media thickness (cIMT) have been used as a valid measure of subclinical atherosclerosis and as a tool to predict the risk of cardiovascular events. Our aim was to evaluate the progression of cIMT in HIV-infected patients subjected to cART, with and without lipodystrophy, over a one-year period.

Methods: We performed a one-year prospective cohort study to compare changes in cIMT, metabolic and inflammation markers in HIV-infected patients undergoing cART. Body composition was assessed by dual-energy X-ray absorptiometry (DXA) and abdominal computed tomography (CT). Levels of blood pressure, lipids and inflammatory markers were evaluated, as well as ultrasound measures of cIMT. Lipodystrophy defined by Fat Mass Ratio (L-FMR) is measured as the ratio of the percentage of trunk fat mass to the percentage of lower limb fat mass by DXA. Categorical variables were compared, using the chi-square or Fisher's exact test. Wilcoxon ranks tests and the McNemar chi-square tests were used to compare results of selected variables, from the first to the second year of evaluation. Means of cIMT, adjusted for age, glucose, triglycerides levels, systolic blood pressure (SBP), and waist to hip ratio were calculated, using generalised linear models for repeated measures.

Results: L-FMR was present in 44.3% of patients, and the mean of cIMT increased significantly in this group [0.82 (0.26) vs 0.92 (0.33); p = 0.037], as well as in patients without lipodystrophy [0.73 (0.20) vs 0.84 (0.30); p = 0.012]. In the overall sample, the progression of cIMT was statistically significant after the adjustment for age, glucose, triglycerides, and SBP, but the significance of the progression ceased after the adjustment for waist/hip ratio [0.770 (0.737-0.803) vs 0.874 (0.815-0.933); p = 0.514].

Conclusions: Carotid IMT progressed significantly in both groups of this HIV-infected cohort, however no association between the progression of cIMT and the presence of lipodystrophy defined by FMR was found. Visceral adipose tissue had an impact on the increment of cIMT, both in patients with, and without lipodystrophy defined by FMR.

Keywords: Carotid intima media thickness; Fat mass ratio; HIV; Lipodystrophy.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

All patients provided written informed consent and the study protocol was approved by the São João Hospital’s Ethics Committee for Health.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Hogg R, Lima V, Sterne JA, Grabar S, Battegay M, Bonarek M, D'Arminio Monforte A, Esteve A, Gill MJ, Harris R, Justice A, Hayden A, Lampe F, Mocroft A, Mugavero MJ, Staszewski S, Wasmuth JC, van Sighem A, Kitahata M, Guest J, Egger M, May M. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372:293–299. doi: 10.1016/S0140-6736(08)61113-7. - DOI - PMC - PubMed
    1. Palella FJ, Delaney KM, Moorman AC, Loveles MO, Fuher J, SattenGA, Aschman DJ, Holmberg SD: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection: HIV outpatient study investigators. N Engl J Med 1998;338:853–860. - PubMed
    1. Lichtenstein KA. Redefining lipodystrophy syndrome: risks and impact on clinical decision making. J Acquir Immune Defic Syndr. 2005;39(4):395–400. doi: 10.1097/01.qai.0000167478.28051.3a. - DOI - PubMed
    1. Brown TT, Li X, Cole SR, Kingsley LA, Palella FJ, Riddler SA, Chimel JS, Visscher BR, Margolick JB, Dobs AS. Cumulative exposure to nucleoside analogue reverse transcriptase inhibitors is associated with insulin resistance markers in the multicenter AIDS cohort study. AIDS. 2005;19(13):1375–1383. doi: 10.1097/01.aids.0000181011.62385.91. - DOI - PubMed
    1. van Vonderen MGA, Smulders YM, Stehouwer CD, Danner SA, Gundy CM, Vos F, Reiss P, van Agtmael MA. Carotid intima-media thickness and arterial stiffness in HIV-infected patients: the role of HIV, antiretroviral therapy and Lipodystrophy. J Acquir Immune Defic Syndr. 2009;50:153–161. doi: 10.1097/QAI.0b013e31819367cd. - DOI - PubMed

Publication types

MeSH terms