Rachel L Goldberg, Tess E Peterson, Sabina A Haberlen, Mallory D Witt, Frank J Palella, Jared W Magnani, Todd T Brown, Jordan E Lake, Joao A C Lima, Matt J Budoff, Chiadi E Ndumele, Katherine C Wu, Wendy S Post
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We investigated associations of visceral adipose tissue, subcutaneous adipose tissue, and other fat depots with subclinical diastolic dysfunction among men with and without HIV (MWH and MWOH).</p><p><strong>Design: </strong>Cross-sectional analysis of MWH and MWOH in the Multicenter AIDS Cohort Study (MACS).</p><p><strong>Methods: </strong>Participants underwent echocardiography for diastolic dysfunction assessment and CT scanning including subcutaneous, visceral, epicardial, and liver adiposity measurements. Diastolic dysfunction was defined by characterizing heart function on antiretroviral therapy0 criteria. Odds for diastolic dysfunction with each measure of adiposity were estimated using multivariable logistic regression.</p><p><strong>Results: </strong>Among 403 participants (median age 57, 55% white, median BMI 26 kg/m 2 ), 25% met criteria for diastolic dysfunction and 59% MWH (82% undetectable plasma HIV RNA). 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引用次数: 0
摘要
背景：艾滋病毒感染者（PWH）与未感染艾滋病毒者（PWOH）相比，发生舒张功能障碍（DD）的风险更大。内脏脂肪组织（AT）的增加在艾滋病病毒感染者中很常见，而内脏脂肪组织的增加与艾滋病病毒感染者的舒张功能障碍有关。我们调查了感染和未感染 HIV 的男性（MWH/MWOH）中内脏脂肪组织、皮下脂肪组织和其他脂肪层与亚临床 DD 的关系：设计：对多中心艾滋病队列研究（MACS）中的 MWH 和 MWOH 进行横断面分析：方法：参与者接受超声心动图检查以评估DD，并接受包括皮下、内脏、心外膜和肝脏脂肪测量在内的CT扫描。DD根据抗逆转录病毒疗法心功能特征标准进行定义。采用多变量逻辑回归法估算了每种脂肪测量值的DD几率：在 403 名参与者（中位年龄 57 岁，55% 白人，中位体重指数 26 kg/m2）中，25% 符合 DD 标准，59% 符合 MWH 标准（82% 检测不到血浆 HIV RNA）。经人口统计学、HIV 血清状态和心血管风险因素调整后，更大的心外膜 AT 面积与更高的 DD 发生几率相关（几率比：1.54/SD；95%CI：1.15-2.05）。这种关联并不因 HIV 血清状态而异，而且在排除未被病毒抑制的 MWH 后仍然存在。较少的皮下脂肪与较高的DD几率相关。其他脂肪库与 DD 无关：结论：无论艾滋病毒血清状态和病毒抑制情况如何，心外膜AT增加和皮下AT减少都与DD有关。在PWH人群中观察到的心外膜AT较大而皮下AT较小的现象可能会导致该人群出现射血分数保留型心力衰竭的风险。
Associations between epicardial, visceral, and subcutaneous adipose tissue with diastolic function in men with and without HIV.
Background: People with HIV (PWH) are at greater risk for diastolic dysfunction compared with persons without HIV (PWOH). An increase in visceral adipose tissue is common among PWH and greater visceral adipose tissue is associated with diastolic dysfunction among PWOH. We investigated associations of visceral adipose tissue, subcutaneous adipose tissue, and other fat depots with subclinical diastolic dysfunction among men with and without HIV (MWH and MWOH).
Design: Cross-sectional analysis of MWH and MWOH in the Multicenter AIDS Cohort Study (MACS).
Methods: Participants underwent echocardiography for diastolic dysfunction assessment and CT scanning including subcutaneous, visceral, epicardial, and liver adiposity measurements. Diastolic dysfunction was defined by characterizing heart function on antiretroviral therapy0 criteria. Odds for diastolic dysfunction with each measure of adiposity were estimated using multivariable logistic regression.
Results: Among 403 participants (median age 57, 55% white, median BMI 26 kg/m 2 ), 25% met criteria for diastolic dysfunction and 59% MWH (82% undetectable plasma HIV RNA). Greater epicardial adipose tissue area was associated with higher odds of diastolic dysfunction [odds ratio:1.54 per SD; 95%confidence interval (CI) 1.15-2.05] when adjusted for demographics, HIV serostatus, and cardiovascular risk factors. This association did not differ by HIV serostatus and persisted when excluding MWH who were not virally suppressed. Less subcutaneous adipose tissue was associated with higher odds of diastolic dysfunction. Other adipose depots were not associated with diastolic dysfunction.
Conclusion: Greater epicardial adipose tissue and less subcutaneous adipose tissue were associated with diastolic dysfunction, regardless of HIV serostatus and viral suppression. Greater epicardial adipose tissue and less subcutaneous adipose tissue observed among PWH may contribute to risk for heart failure with preserved ejection fraction in this population.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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