Daniele Pastori, Francesco Del Sole, Tommaso Brogi, Maria Del Ben, Caterina Fimiani, Claudio Maria Mastroianni, Ivano Mezzaroma
{"title":"用 ARFI 弹性成像技术测量无肝脏疾病的 1 型人类免疫缺陷病毒(HIV-1)感染者的心外膜脂肪和肝脏硬度。","authors":"Daniele Pastori, Francesco Del Sole, Tommaso Brogi, Maria Del Ben, Caterina Fimiani, Claudio Maria Mastroianni, Ivano Mezzaroma","doi":"10.1097/QAD.0000000000004028","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between increased epicardial fat thickness (EFT) and liver stiffness measurement (LSM), as assessed by elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection (PWH).</p><p><strong>Methods: </strong>91 PWH on effective antiretroviral treatment (ART) were enrolled. EFT was measured by transthoracic echocardiography. Liver steatosis was evaluated by ultrasound Hamaguchi criteria and LSM by elastography with Acoustic Radiation Force Impulse (ARFI) Tecnique. LSM ≥8 Kpa was suggestive of clinically relevant fibrosis.</p><p><strong>Results: </strong>Mean age was 54.3 years and 27.5% were women. EFT correlated with HIV-1 infection duration (rS 0.252, p = 0.016), age at study entry (rS 0.527, p < 0.001), BMI (rS 0.363, p < 0.001), waist circumference (rS 0.549, p < 0.001), HDL (rS -0.391, p < 0.001), triglycerides (rS 0.375, p < 0.001), Hamaguchi score (rS 0.279, p = 0.007), right lobe of the liver (rS 0.259, p = 0.014), Left ventricular mass/Body surface area (rS 0.220, p = 0.036).A LSM ≥8 Kpa was found in 20.9% of PWH, more commonly in those with EFT above the median >5.6 mm (30.4% vs 11.1%, p = 0.038). LSM significantly correlated with EFT (rS 0.274, p = 0.009), CD4+ cells (rS -0.320, p = 0.003) and nadir of CD4+ cells (rS -0.292, p = 0.007).In a subgroup (n = 53), an HOMA-IR index >2.33 identified increased EFT, (AUC 0.73, 95%CI 0.59-0.84, p = 0.001) while an HOMA-IR >3.27 predicted increased LSM (AUC 0.76, 95%CI 0.62-0.87, p = 0.005).</p><p><strong>Conclusions: </strong>PWH with increased EFT have worse metabolic profile and a high proportion of clinically relevant fibrosis at ARFI elastography, despite normal liver function tests. The HOMA-IR index might be used to identify PWH with increased EFT and liver fibrosis.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epicardial fat and liver stiffness by ARFI elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection without liver disease.\",\"authors\":\"Daniele Pastori, Francesco Del Sole, Tommaso Brogi, Maria Del Ben, Caterina Fimiani, Claudio Maria Mastroianni, Ivano Mezzaroma\",\"doi\":\"10.1097/QAD.0000000000004028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the association between increased epicardial fat thickness (EFT) and liver stiffness measurement (LSM), as assessed by elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection (PWH).</p><p><strong>Methods: </strong>91 PWH on effective antiretroviral treatment (ART) were enrolled. EFT was measured by transthoracic echocardiography. Liver steatosis was evaluated by ultrasound Hamaguchi criteria and LSM by elastography with Acoustic Radiation Force Impulse (ARFI) Tecnique. LSM ≥8 Kpa was suggestive of clinically relevant fibrosis.</p><p><strong>Results: </strong>Mean age was 54.3 years and 27.5% were women. EFT correlated with HIV-1 infection duration (rS 0.252, p = 0.016), age at study entry (rS 0.527, p < 0.001), BMI (rS 0.363, p < 0.001), waist circumference (rS 0.549, p < 0.001), HDL (rS -0.391, p < 0.001), triglycerides (rS 0.375, p < 0.001), Hamaguchi score (rS 0.279, p = 0.007), right lobe of the liver (rS 0.259, p = 0.014), Left ventricular mass/Body surface area (rS 0.220, p = 0.036).A LSM ≥8 Kpa was found in 20.9% of PWH, more commonly in those with EFT above the median >5.6 mm (30.4% vs 11.1%, p = 0.038). LSM significantly correlated with EFT (rS 0.274, p = 0.009), CD4+ cells (rS -0.320, p = 0.003) and nadir of CD4+ cells (rS -0.292, p = 0.007).In a subgroup (n = 53), an HOMA-IR index >2.33 identified increased EFT, (AUC 0.73, 95%CI 0.59-0.84, p = 0.001) while an HOMA-IR >3.27 predicted increased LSM (AUC 0.76, 95%CI 0.62-0.87, p = 0.005).</p><p><strong>Conclusions: </strong>PWH with increased EFT have worse metabolic profile and a high proportion of clinically relevant fibrosis at ARFI elastography, despite normal liver function tests. The HOMA-IR index might be used to identify PWH with increased EFT and liver fibrosis.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004028\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004028","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Epicardial fat and liver stiffness by ARFI elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection without liver disease.
Objective: To evaluate the association between increased epicardial fat thickness (EFT) and liver stiffness measurement (LSM), as assessed by elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection (PWH).
Methods: 91 PWH on effective antiretroviral treatment (ART) were enrolled. EFT was measured by transthoracic echocardiography. Liver steatosis was evaluated by ultrasound Hamaguchi criteria and LSM by elastography with Acoustic Radiation Force Impulse (ARFI) Tecnique. LSM ≥8 Kpa was suggestive of clinically relevant fibrosis.
Results: Mean age was 54.3 years and 27.5% were women. EFT correlated with HIV-1 infection duration (rS 0.252, p = 0.016), age at study entry (rS 0.527, p < 0.001), BMI (rS 0.363, p < 0.001), waist circumference (rS 0.549, p < 0.001), HDL (rS -0.391, p < 0.001), triglycerides (rS 0.375, p < 0.001), Hamaguchi score (rS 0.279, p = 0.007), right lobe of the liver (rS 0.259, p = 0.014), Left ventricular mass/Body surface area (rS 0.220, p = 0.036).A LSM ≥8 Kpa was found in 20.9% of PWH, more commonly in those with EFT above the median >5.6 mm (30.4% vs 11.1%, p = 0.038). LSM significantly correlated with EFT (rS 0.274, p = 0.009), CD4+ cells (rS -0.320, p = 0.003) and nadir of CD4+ cells (rS -0.292, p = 0.007).In a subgroup (n = 53), an HOMA-IR index >2.33 identified increased EFT, (AUC 0.73, 95%CI 0.59-0.84, p = 0.001) while an HOMA-IR >3.27 predicted increased LSM (AUC 0.76, 95%CI 0.62-0.87, p = 0.005).
Conclusions: PWH with increased EFT have worse metabolic profile and a high proportion of clinically relevant fibrosis at ARFI elastography, despite normal liver function tests. The HOMA-IR index might be used to identify PWH with increased EFT and liver fibrosis.
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.