CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy

Jordan E. Lake, Carlee Moser, Liz Johnston, Clara Magyar, Scott D. Nelson, Kristine M. Erlandson, Todd T Brown, Grace A. McComsey

Research output: Contribution to journalArticle

Abstract

CONTEXT: Microscopic measurement of adipocyte size is the gold standard for determining adipose tissue (AT) quality. AT density on CT may also reflect adipocyte quality (lower density = poorer quality). OBJECTIVE: We used abdominal subcutaneous AT (SAT) specimens and CT scans to validate CT SAT density as a marker of SAT quality in adults living with HIV. SETTING AND DESIGN: Secondary data analysis from completed trial of antiretroviral therapy (ART) initiation (ACTG A5224s). CT abdominal SAT density was measured in HU. SAT specimens were digitally scanned for calculation of mean adipocyte area. PARTICIPANTS: Participants had SAT biopsy and CT data at baseline (n = 54) and HIV-1 RNA <50 copies per milliliter on ART and biopsy or CT data at week 96 (n = 30). OUTCOME MEASURES: Spearman correlations and linear regression models adjusting for participant characteristics examined associations between SAT density and adipocyte area. RESULTS: Baseline median age was 40 years, CD4+ T lymphocyte count 219 cells per cubic millimeter, and body mass index 26.0 kg/m2; 89% were male and 67% white. Median SAT area and density were 199 cm2 and -100 HU. Over 96 weeks, SAT area increased (+18%) and SAT density decreased (-3%). Mean SAT adipocyte area correlated with SAT density (P < 0.01) off and on ART after adjustment for SAT area, age, race, sex, CD4+ T lymphocyte count, and HIV-1 RNA. CONCLUSIONS: CT SAT density correlates with biopsy-quantified SAT adipocyte size in adults with HIV on and off ART, suggesting that CT is a useful tool for noninvasive assessment of SAT quality.

Original languageEnglish (US)
Pages (from-to)4857-4864
Number of pages8
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number10
DOIs
StatePublished - Oct 1 2019

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Biopsy
Adipocytes
T-cells
Fats
HIV
Tissue
RNA
Computerized tomography
CD4 Lymphocyte Count
Linear regression
Adipose Tissue
HIV-1
Linear Models
Therapeutics
Abdominal Subcutaneous Fat
T-Lymphocytes
Body Mass Index

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Lake, J. E., Moser, C., Johnston, L., Magyar, C., Nelson, S. D., Erlandson, K. M., ... McComsey, G. A. (2019). CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy. The Journal of clinical endocrinology and metabolism, 104(10), 4857-4864. https://doi.org/10.1210/jc.2018-02785

CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy. / Lake, Jordan E.; Moser, Carlee; Johnston, Liz; Magyar, Clara; Nelson, Scott D.; Erlandson, Kristine M.; Brown, Todd T; McComsey, Grace A.

In: The Journal of clinical endocrinology and metabolism, Vol. 104, No. 10, 01.10.2019, p. 4857-4864.

Research output: Contribution to journalArticle

Lake, Jordan E. ; Moser, Carlee ; Johnston, Liz ; Magyar, Clara ; Nelson, Scott D. ; Erlandson, Kristine M. ; Brown, Todd T ; McComsey, Grace A. / CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy. In: The Journal of clinical endocrinology and metabolism. 2019 ; Vol. 104, No. 10. pp. 4857-4864.
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AU - Moser, Carlee

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AU - Magyar, Clara

AU - Nelson, Scott D.

AU - Erlandson, Kristine M.

AU - Brown, Todd T

AU - McComsey, Grace A.

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N2 - CONTEXT: Microscopic measurement of adipocyte size is the gold standard for determining adipose tissue (AT) quality. AT density on CT may also reflect adipocyte quality (lower density = poorer quality). OBJECTIVE: We used abdominal subcutaneous AT (SAT) specimens and CT scans to validate CT SAT density as a marker of SAT quality in adults living with HIV. SETTING AND DESIGN: Secondary data analysis from completed trial of antiretroviral therapy (ART) initiation (ACTG A5224s). CT abdominal SAT density was measured in HU. SAT specimens were digitally scanned for calculation of mean adipocyte area. PARTICIPANTS: Participants had SAT biopsy and CT data at baseline (n = 54) and HIV-1 RNA <50 copies per milliliter on ART and biopsy or CT data at week 96 (n = 30). OUTCOME MEASURES: Spearman correlations and linear regression models adjusting for participant characteristics examined associations between SAT density and adipocyte area. RESULTS: Baseline median age was 40 years, CD4+ T lymphocyte count 219 cells per cubic millimeter, and body mass index 26.0 kg/m2; 89% were male and 67% white. Median SAT area and density were 199 cm2 and -100 HU. Over 96 weeks, SAT area increased (+18%) and SAT density decreased (-3%). Mean SAT adipocyte area correlated with SAT density (P < 0.01) off and on ART after adjustment for SAT area, age, race, sex, CD4+ T lymphocyte count, and HIV-1 RNA. CONCLUSIONS: CT SAT density correlates with biopsy-quantified SAT adipocyte size in adults with HIV on and off ART, suggesting that CT is a useful tool for noninvasive assessment of SAT quality.

AB - CONTEXT: Microscopic measurement of adipocyte size is the gold standard for determining adipose tissue (AT) quality. AT density on CT may also reflect adipocyte quality (lower density = poorer quality). OBJECTIVE: We used abdominal subcutaneous AT (SAT) specimens and CT scans to validate CT SAT density as a marker of SAT quality in adults living with HIV. SETTING AND DESIGN: Secondary data analysis from completed trial of antiretroviral therapy (ART) initiation (ACTG A5224s). CT abdominal SAT density was measured in HU. SAT specimens were digitally scanned for calculation of mean adipocyte area. PARTICIPANTS: Participants had SAT biopsy and CT data at baseline (n = 54) and HIV-1 RNA <50 copies per milliliter on ART and biopsy or CT data at week 96 (n = 30). OUTCOME MEASURES: Spearman correlations and linear regression models adjusting for participant characteristics examined associations between SAT density and adipocyte area. RESULTS: Baseline median age was 40 years, CD4+ T lymphocyte count 219 cells per cubic millimeter, and body mass index 26.0 kg/m2; 89% were male and 67% white. Median SAT area and density were 199 cm2 and -100 HU. Over 96 weeks, SAT area increased (+18%) and SAT density decreased (-3%). Mean SAT adipocyte area correlated with SAT density (P < 0.01) off and on ART after adjustment for SAT area, age, race, sex, CD4+ T lymphocyte count, and HIV-1 RNA. CONCLUSIONS: CT SAT density correlates with biopsy-quantified SAT adipocyte size in adults with HIV on and off ART, suggesting that CT is a useful tool for noninvasive assessment of SAT quality.

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