title: Regional fat deposition and cardiovascular risk in HIV infection: the FRAM study.
abstract: HIV-infected individuals are at increased risk for cardiovascular disease (CVD) and lipodystrophy, but the relationship between regional adipose tissue (AT) depots and CVD risk is not well described. We determined regional AT volumes and CVD risk in an analysis of 586 HIV-infected and 280 control FRAM study subjects using whole-body magnetic resonance imaging (MRI) and the Framingham Risk Score (FRS). Median FRS and FRS >10% were higher in HIV than control men (4.7% vs. 3.7%, p=0.0002; 16% vs. 4%, p<0.0001). HIV and control women had similarly low FRS (1.1% vs. 1.2%, p=0.91). In controls, total AT and all regional AT depots showed strong positive correlations with FRS (p<0.001) in men and weaker positive correlations in women. Greater visceral AT (VAT) and lower leg subcutaneous AT (SAT) volumes were associated with elevated FRS in HIV subjects with a trend for upper trunk SAT. Controls in the lowest quartile of leg SAT had the lowest FRS (1.5%), whereas HIV with similarly low leg SAT had the highest FRS (4.0%, p<0.001 vs. controls). Increased VAT is associated with CVD risk, but the risk is higher in HIV-infected individuals relative to controls at every level of VAT. Peripheral lipoatrophy (as measured by leg SAT) is associated with striking increased CVD risk in HIV-infected patients even after controlling for VAT, whereas low leg SAT is associated with low CVD risk in controls.
authors.affiliation: Division of Infectious Diseases, CARE Center, UCLA , Los Angeles, CA, USA.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.forename: David
authors.initials: D
authors.lastname: Wohl
authors.forename: Rebecca
authors.initials: R
authors.lastname: Scherzer
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.forename: Judith S
authors.initials: JS
authors.lastname: Currier
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D050218:Body Fat Distribution; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism / Q000473:pathology; D007866:Leg / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000378:metabolism / Q000473:pathology; D051598:Whole Body Imaging