Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indicates persistence of HIV-associated lipoatrophy

Carl Grunfeld, Michael Saag, Joseph Cofrancesco, Cora Elizabeth Lewis, Richard Kronmal, Steven Heymsfield, Phyllis C. Tien, Peter Bacchetti, Michael Shlipak, Rebecca Scherzer

Research output: Contribution to journalArticle

Abstract

Objective: Peripheral fat loss and visceral fat gain have been reported in HIV infection. There are limited data on long-term change in adipose tissue in HIV-infected patients vs. controls. Therefore, we determined change in regional adipose tissue from baseline examination to 5 years later among participants in the study of Fat Redistribution and Metabolic Change in HIV Infection. Methods: Regional adipose tissue volume was measured using MRI at both examinations in 477 HIV-infected and 214 control men and women. Lipoatrophy was defined as leg subcutaneous adipose tissue (SAT) below the cutoff point marking the lowest decile (10%) of controls at each examination. Results: HIV-infected and control participants showed similar adipose tissue gains. In men, all SAT depots and visceral adipose tissue started lower and remained lower on average in HIV-infected vs. controls. In women, leg and arm SAT also started lower and remained lower in HIV-infected vs. controls. Mean leg SAT of HIV-infected men was 67% of control men at baseline and 65% at follow-up; for women 83% and 77%. At baseline, 48% of HIV-infected participants had lipoatrophy; on average those with baseline lipoatrophy gained 0.96L of leg SAT compared with 1.23L gain for controls in the lowest decile (P = 0.16). At follow-up, 53% of HIV-infected participants had lipoatrophy. In multivariable models, discontinuation of stavudine appeared to produce little gain in leg SAT (∼1.1%/year). Conclusion: HIV-infected participants did not substantially recover SAT compared with controls, although both showed average gains. HIV-associated lipoatrophy persisted after 5 years of follow-up.

Original languageEnglish (US)
Pages (from-to)1717-1726
Number of pages10
JournalAIDS
Volume24
Issue number11
DOIs
StatePublished - Jul 17 2010

Keywords

  • HIV infection
  • body composition
  • fat redistribution
  • lipoatrophy
  • lipodystrophy
  • lipohypertrophy
  • visceral obesity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Grunfeld, C., Saag, M., Cofrancesco, J., Lewis, C. E., Kronmal, R., Heymsfield, S., Tien, P. C., Bacchetti, P., Shlipak, M., & Scherzer, R. (2010). Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indicates persistence of HIV-associated lipoatrophy. AIDS, 24(11), 1717-1726. https://doi.org/10.1097/QAD.0b013e32833ac7a2