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Regional fat deposition and cardiovascular risk in HIV infection: the FRAM study

Jordan E Lake1, David Wohl, Rebecca Scherzer

  • 1Division of Infectious Diseases, CARE Center, UCLA , Los Angeles, CA, USA.

AIDS Care
|July 20, 2011
PubMed

Insights

HIV-infected men have higher cardiovascular disease (CVD) risk, linked to visceral adipose tissue (VAT) and reduced leg fat. This risk is amplified in HIV patients compared to controls, even with similar fat distribution.

Area of Science:

  • Cardiology
  • Endocrinology
  • Infectious Diseases

Background:

  • HIV infection is associated with increased cardiovascular disease (CVD) and lipodystrophy.
  • The specific relationship between regional adipose tissue (AT) depots and CVD risk in HIV-infected individuals requires further elucidation.

Purpose of the Study:

  • To determine regional AT volumes and CVD risk in HIV-infected individuals and controls.
  • To investigate the association between specific AT depots and CVD risk scores in the context of HIV infection.

Main Methods:

  • Analysis of 586 HIV-infected and 280 control subjects from the FRAM study.
  • Whole-body magnetic resonance imaging (MRI) to measure regional AT volumes.
  • Framingham Risk Score (FRS) calculation to assess CVD risk.

Main Results:

  • HIV-infected men exhibited higher median FRS and prevalence of FRS >10% compared to control men.
  • In HIV-infected individuals, greater visceral AT (VAT) and lower leg subcutaneous AT (SAT) volumes were associated with elevated FRS.
  • Peripheral lipoatrophy (low leg SAT) was linked to significantly increased CVD risk in HIV patients, a relationship not observed in controls.

Conclusions:

  • Increased VAT is a risk factor for CVD, with a higher relative risk in HIV-infected individuals.
  • Peripheral lipoatrophy, indicated by reduced leg SAT, is independently associated with substantially increased CVD risk in HIV-infected patients.
  • The distribution of AT, particularly VAT and leg SAT, plays a critical role in CVD risk stratification among HIV-infected individuals.

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