title: Ultrasound-assessed perirenal fat is related to increased ophthalmic artery resistance index in HIV-1 patients.
abstract: BACKGROUND
  The introduction of highly active antiretroviral therapy (HAART) has dramatically changed the prognosis of human immunodeficiency virus (HIV) infection, with a significant decline in morbidity and mortality.Changes in body fat distribution are a common finding in individuals with HIV infection being treated with antiretrovirals, and this condition (collectively termed lipodystrophy syndrome) is associated with depletion of subcutaneous fat, increased triglycerides and insulin resistance. Obesity, particularly visceral obesity, is associated with increased risk of cardiovascular disease. Therefore, estimating visceral fat distribution is important in identifying subjects at high risk for cardiovascular disease.The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a parameter of central obesity, is related to ophthalmic artery resistance index (OARI), an index of occlusive carotid artery disease in HIV-1 infected patients.
  
  
  METHODS
  We enrolled 88 consecutive HIV-1-infected patients receiving highly active antiretroviral therapy for more than 12 months, in a prospective cohort study. Echographically measured PRFT and OARI, as well as serum metabolic parameters, were evaluated. PRFT and OARI were measured by 3.75 MHz convex and 7.5 MHz linear probe, respectively.
  
  
  RESULTS
  The means of PRFT and OARI in HIV-1-infected patients with visceral obesity was considerably higher than in patients without it (p < 0.0001 and p < 0.001, respectively). Using the average OARI as the dependent variable, total serum cholesterol level, HDL, triglycerides, glycemia, sex, blood pressure, age and PRFT were independent factors associated with OARI. A PRFT of 6.1 mm was the most discriminatory value for predicting an OARI > 0.74 (sensitivity 78.9%, specificity 82.8%).
  
  
  CONCLUSIONS
  Our data indicate that ultrasound assessment of PRFT may have potential as a marker of increased endothelial damage with specific involvement of the ocular vascular region in HIV-1-infected patients.
authors.affiliation: Division of Infectious Diseases, HIV Center, S, Caterina Novella Hospital, Galatina, Italy. pierfrancescogrima@yahoo.it
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Grima
authors.forename: Marcello
authors.initials: M
authors.lastname: Guido
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiavaroli
authors.forename: Antonella
authors.initials: A
authors.lastname: Zizza
mesh_terms: D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D002340:Carotid Artery Diseases / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000000981:diagnostic imaging*; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D014463:Ultrasonography; D014655:Vascular Resistance