Epicardial adipose tissue is related to carotid intima-media thickness and visceral adiposity in HIV-infected patients with highly active antiretroviral therapy-associated metabolic syndrome.
BACKGROUND
High cardiovascular risk and accelerated atherosclerosis are associated with human immunodeficiency virus (HIV). Recently, the use of highly active antiretroviral therapy (HAART) for the treatment of HIV infection is correlated with the development of HAART-associated metabolic syndrome and lipodystrophy (LDS). Detection of epicardial fat thickness, new index of visceral adiposity in non HIV-infected patients, might be important as diagnostic tool in HIV-infected patients on HAART.


OBJECTIVE
Primary objective of this study was to evaluate whether echocardiographic epicardial adipose tissue is related to visceral adipose tissue (VAT) and Carotid Intima-Media Thickness (IMT), index of atherosclerosis in HIV-infected patients on HAART with LDS.


METHODS
We studied 60 consecutive HIV-infected subjects with HAART-associated metabolic syndrome and LDS and 45 HIV-infected subjects on HAART without LDS.


METHODS
Epicardial fat thickness and IMT were measured by ultrasonography in both study and control groups. Magnetic resonance imaging (MRI) was used to calculate VAT in HIV-infected subjects on HAART with LDS.


RESULTS
Epicardial adipose tissue thickness showed an excellent correlation with MRI-VAT (r=0.85; P<0.001) and IMT (r=0.78;P<0.001) in HIV-infected patients on HAART-with LDS. Multiple regression analysis showed that epicardial fat thickness was best predicted by MRI-VAT and IMT (R2=0.57, p<0.001 and p<0.01, respectively). HIV-infected patients with HAART-associated metabolic syndrome and LDS showed higher epicardial fat thickness and IMT (8 vs 6.5 mm; 0.71 vs 0.66 mm, respectively, p<0.01 for both) than HIV-infected subjects on HAART without LDS.


CONCLUSIONS
Echocardiographic assessment of epicardial fat may have the potential to be a simple and reliable marker of visceral adiposity and increased cardiovascular risk in HIV-infected patients with HAART-associated metabolic syndrome and LDS.
Iacobellis
Gianluca
G
Cardiovascular Obesity Research and Management at the Michael G deGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada. gianluca@cardio.on.ca
Sharma
Arya M
AM
Pellicelli
Adriano M
AM
Grisorio
Benvenuto
B
Barbarini
Giorgio
G
Barbaro
Giuseppe
G
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D050197:Atherosclerosis / Q000175:diagnosis; D015415:Biomarkers; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D004452:Echocardiography; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000503:physiopathology*; D008875:Middle Aged; D010496:Pericardium / Q000187:drug effects*; D018570:Risk Assessment; D017539:Tunica Intima / Q000033:anatomy & histology / Q000000981:diagnostic imaging
D015415:Biomarkers