title: Independent associations of insulin resistance with high whole-body intermuscular and low leg subcutaneous adipose tissue distribution in obese HIV-infected women.
abstract: BACKGROUND
  Obesity and insulin resistance are growing problems in HIV-positive (HIV+) women receiving highly active antiretroviral therapy (HAART).
  
  
  OBJECTIVE
  The objective was to determine the contribution of adipose tissue (AT) enlargement and distribution to the presence of insulin resistance in obese HIV+ women.
  
  
  METHODS
  Whole-body intermuscular AT (IMAT), visceral AT (VAT), subcutaneous AT (SAT), and SAT distribution (leg versus upper body) were measured by whole-body magnetic resonance imaging. Insulin sensitivity (S(I)) was measured with an intravenous glucose tolerance test in obese HIV+ women recruited because of their desire to lose weight (n=17) and in obese healthy controls (n=32).
  
  
  RESULTS
  The HIV+ women had relatively less whole-body SAT and more VAT and IMAT than did the controls (P<0.05 for all). A significant interaction by HIV status was observed for the relation of total SAT with S(I) (P<0.001 for the regression's slope interactions after adjustment for age, height, and weight). However, relations of IMAT, VAT, and SAT distribution (leg SAT as a percentage of total SAT; leg SAT%) with S(I) did not differ significantly between groups. For both groups combined, the best model predicting a low S(I) included significant contributions by both high IMAT and low leg SAT%, independent of age, height, and weight, and no interaction between groups was observed (overall r(2)=0.44, P=0.0003).
  
  
  CONCLUSIONS
  In obese HIV+ women, high whole-body IMAT and low leg SAT% distribution are independently associated with insulin resistance.
authors.affiliation: Endocrine, Diabetes and Nutrition Division, the New York Obesity Research Center, St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. jba1@columbia.edu
authors.forename: Jeanine B
authors.initials: JB
authors.lastname: Albu
authors.forename: Sonjia
authors.initials: S
authors.lastname: Kenya
authors.forename: Qing
authors.initials: Q
authors.lastname: He
authors.forename: Marsha
authors.initials: M
authors.lastname: Wainwright
authors.forename: Evan S
authors.initials: ES
authors.lastname: Berk
authors.forename: Stanley
authors.initials: S
authors.lastname: Heshka
authors.forename: Donald P
authors.initials: DP
authors.lastname: Kotler
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Engelson
mesh_terms: D050153:Abdominal Fat / Q000473:pathology*; D000328:Adult; D005260:Female; D005951:Glucose Tolerance Test; D006678:HIV / Q000254:growth & development*; D015658:HIV Infections / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000378:metabolism* / Q000473:pathology / Q000821:virology*; D050151:Subcutaneous Fat / Q000473:pathology*