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Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS).
J Cardiovasc Comput Tomogr. 2018 Mar - Apr; 12(2):131-138.JC

Abstract

BACKGROUND

HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown.

METHODS

We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010-2013. Of these, 379 also underwent coronary CT angiography for non-calcified coronary plaque (NCP) and obstructive coronary stenosis ≥50%. Multivariable-adjusted Poisson regression was used to estimate prevalence risk ratios of associations between low muscle mass (<20th percentile of the HIV-uninfected individuals in the sample) and CAC, NCP and obstructive stenosis.

RESULTS

The prevalence of low thigh muscle mass was similar by HIV serostatus (20%). There was no association of low muscle mass with CAC or NCP. However, low thigh muscle mass was significantly associated with a 2.5-fold higher prevalence of obstructive coronary stenosis, after adjustment for demographics and traditional CAD risk factors [PR 2.46 (95% CI 1.51, 4.01)]. This association remained significant after adjustment for adiposity, inflammation, and physical activity. There was no significant interaction by HIV serostatus (p-interaction = 0.90).

CONCLUSIONS

In this exploratory analysis, low thigh muscle mass was significantly associated with subclinical obstructive coronary stenosis. Additional studies involving larger sample sizes and prospective analyses are needed to confirm the potential utility of measuring mid-thigh muscle mass for identifying individuals at increased risk for obstructive CAD who might benefit from more aggressive risk factor management.

Authors+Show Affiliations

Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Medicine, St. Luke's Hospital, Chesterfield, MO, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, USA.Division of Infectious Diseases, Ohio State University, Columbus, OH, USA.Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Northeast Ohio Medical University, Rootstown, OH, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, USA.Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: edonnell@jhmi.edu.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

29396194

Citation

Tibuakuu, Martin, et al. "Low Thigh Muscle Mass Is Associated With Coronary Artery Stenosis Among HIV-infected and HIV-uninfected Men: the Multicenter AIDS Cohort Study (MACS)." Journal of Cardiovascular Computed Tomography, vol. 12, no. 2, 2018, pp. 131-138.
Tibuakuu M, Zhao D, Saxena A, et al. Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS). J Cardiovasc Comput Tomogr. 2018;12(2):131-138.
Tibuakuu, M., Zhao, D., Saxena, A., Brown, T. T., Jacobson, L. P., Palella, F. J., Witt, M. D., Koletar, S. L., Margolick, J. B., Guallar, E., Korada, S. K. C., Budoff, M. J., Post, W. S., & Michos, E. D. (2018). Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS). Journal of Cardiovascular Computed Tomography, 12(2), 131-138. https://doi.org/10.1016/j.jcct.2018.01.007
Tibuakuu M, et al. Low Thigh Muscle Mass Is Associated With Coronary Artery Stenosis Among HIV-infected and HIV-uninfected Men: the Multicenter AIDS Cohort Study (MACS). J Cardiovasc Comput Tomogr. 2018 Mar - Apr;12(2):131-138. PubMed PMID: 29396194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS). AU - Tibuakuu,Martin, AU - Zhao,Di, AU - Saxena,Ankita, AU - Brown,Todd T, AU - Jacobson,Lisa P, AU - Palella,Frank J,Jr AU - Witt,Mallory D, AU - Koletar,Susan L, AU - Margolick,Joseph B, AU - Guallar,Eliseo, AU - Korada,Sai Krishna C, AU - Budoff,Matthew J, AU - Post,Wendy S, AU - Michos,Erin D, Y1 - 2018/01/31/ PY - 2017/07/24/received PY - 2018/01/16/revised PY - 2018/01/22/accepted PY - 2018/2/6/pubmed PY - 2018/8/28/medline PY - 2018/2/4/entrez KW - Coronary artery stenosis KW - Coronary atherosclerosis KW - HIV-infection KW - Muscle mass KW - Sarcopenia SP - 131 EP - 138 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 12 IS - 2 N2 - BACKGROUND: HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown. METHODS: We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010-2013. Of these, 379 also underwent coronary CT angiography for non-calcified coronary plaque (NCP) and obstructive coronary stenosis ≥50%. Multivariable-adjusted Poisson regression was used to estimate prevalence risk ratios of associations between low muscle mass (<20th percentile of the HIV-uninfected individuals in the sample) and CAC, NCP and obstructive stenosis. RESULTS: The prevalence of low thigh muscle mass was similar by HIV serostatus (20%). There was no association of low muscle mass with CAC or NCP. However, low thigh muscle mass was significantly associated with a 2.5-fold higher prevalence of obstructive coronary stenosis, after adjustment for demographics and traditional CAD risk factors [PR 2.46 (95% CI 1.51, 4.01)]. This association remained significant after adjustment for adiposity, inflammation, and physical activity. There was no significant interaction by HIV serostatus (p-interaction = 0.90). CONCLUSIONS: In this exploratory analysis, low thigh muscle mass was significantly associated with subclinical obstructive coronary stenosis. Additional studies involving larger sample sizes and prospective analyses are needed to confirm the potential utility of measuring mid-thigh muscle mass for identifying individuals at increased risk for obstructive CAD who might benefit from more aggressive risk factor management. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/29396194/Low_thigh_muscle_mass_is_associated_with_coronary_artery_stenosis_among_HIV_infected_and_HIV_uninfected_men:_The_Multicenter_AIDS_Cohort_Study__MACS__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(18)30019-4 DB - PRIME DP - Unbound Medicine ER -