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Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study.
BMC Infect Dis 2018; 18(1):32BI

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.

Authors+Show Affiliations

Faculty of Medicine, University of Porto. Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. mimed11100@med.up.pt.Infectious Diseases Department, Centro Hospitalar São João, Porto, Portugal. Renal, Urological and Infectious Diseases Department, Faculty of Medicine of University of Porto, Porto, Portugal.EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.Radiology Department, Hospital de São João and University of Porto Medical School, Porto, Portugal.Nuclear Medicine Department, Hospital de São João, Porto, Portugal.Endocrinology Department, Hospital de São João and University of Porto Medical School, Porto, Portugal.Infectious Diseases Department, Centro Hospitalar São João, Porto, Portugal. Renal, Urological and Infectious Diseases Department, Faculty of Medicine of University of Porto, Porto, Portugal.Endocrinology Department, Hospital de São João and University of Porto Medical School, Porto, Portugal.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29325542

Citation

Beires, Maria Teresa, et al. "Visceral Adipose Tissue and Carotid Intima-media Thickness in HIV-infected Patients Undergoing cART: a Prospective Cohort Study." BMC Infectious Diseases, vol. 18, no. 1, 2018, p. 32.
Beires MT, Silva-Pinto A, Santos AC, et al. Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study. BMC Infect Dis. 2018;18(1):32.
Beires, M. T., Silva-Pinto, A., Santos, A. C., Madureira, A. J., Pereira, J., Carvalho, D., ... Freitas, P. (2018). Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study. BMC Infectious Diseases, 18(1), p. 32. doi:10.1186/s12879-017-2884-9.
Beires MT, et al. Visceral Adipose Tissue and Carotid Intima-media Thickness in HIV-infected Patients Undergoing cART: a Prospective Cohort Study. BMC Infect Dis. 2018 01 11;18(1):32. PubMed PMID: 29325542.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visceral adipose tissue and carotid intima-media thickness in HIV-infected patients undergoing cART: a prospective cohort study. AU - Beires,Maria Teresa, AU - Silva-Pinto,André, AU - Santos,Ana Cristina, AU - Madureira,António José, AU - Pereira,Jorge, AU - Carvalho,Davide, AU - Sarmento,António, AU - Freitas,Paula, Y1 - 2018/01/11/ PY - 2017/06/15/received PY - 2017/12/05/accepted PY - 2018/1/13/entrez PY - 2018/1/13/pubmed PY - 2018/5/16/medline KW - Carotid intima media thickness KW - Fat mass ratio KW - HIV KW - Lipodystrophy SP - 32 EP - 32 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 18 IS - 1 N2 - 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. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/29325542/Visceral_adipose_tissue_and_carotid_intima_media_thickness_in_HIV_infected_patients_undergoing_cART:_a_prospective_cohort_study_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2884-9 DB - PRIME DP - Unbound Medicine ER -