title: Visceral fat is associated with brain structure independent of human immunodeficiency virus infection status.
abstract: The combined effects of human immunodeficiency virus (HIV), obesity, and elevated visceral adipose tissue (VAT) on brain structure are unknown. In a cross-sectional analysis of Multicenter AIDS Cohort Study (MACS) participants, we determined associations between HIV serostatus, adiposity, and brain structure. Men (133 HIV+, 84 HIV-) in the MACS Cardiovascular 2 and magnetic resonance imaging (MRI) sub-studies with CT-quantified VAT and whole brain MRI measured within 1 year were assessed. Voxel-based morphometry analyzed brain volumes. Men were stratified by elevated (eVAT, ≥100cm2) or "normal" (nVAT, <100cm2) VAT. Forward stepwise modeling determined associations between clinical and demographic variables and regional brain volumes. eVAT was present in 67% of men. Groups were similar in age and education, but eVAT men were more likely to be HIV+ and have hypertension, diabetes mellitus, body mass index >25 kg/m2, smaller gray and white matter volumes, and larger cerebrospinal fluid volume than nVAT men. In multivariate analysis, hypertension, higher adiponectin, higher interleukin-6, age, diabetes mellitus, higher body mass index, and eVAT were associated with brain atrophy (p < 0.05, ordered by increasing strength of association), but HIV serostatus and related factors were generally not. No interactions were observed. Greater VAT was associated with smaller bilateral posterior hippocampus and left mesial temporal lobe and temporal stem white matter volume. Traditional risk factors are more strongly associated with brain atrophy than HIV serostatus, with VAT having the strongest association. However, HIV+ MACS men had disproportionately greater VAT, suggesting the risk for central nervous system effects may be amplified in this population.
authors.affiliation: Center for Clinical AIDS Research and Education, University of California, Los Angeles, CA, USA. Jordan.E.Lake@uth.tmc.edu.|University of Texas Health Science Center at Houston, 6431 Fannin St., MSB 2.112, Houston, TX, 77030, USA. Jordan.E.Lake@uth.tmc.edu.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Popov
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Department of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
authors.affiliation: Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Ned
authors.initials: N
authors.lastname: Sacktor
authors.affiliation: Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, CA, USA.
authors.forename: Eric N
authors.initials: EN
authors.lastname: Miller
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.|Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.|Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity / Q000502:physiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D015870:Gene Expression; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D066127:White Matter / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000821:virology
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Brain atrophy; Brain volume; HIV; Visceral fat