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Lipolytic Rate Associated With Intramyocardial Lipid in an HIV Cohort Without Increased Lipolysis
Louisa C Howard1, Chia-Ying Liu1, Julia B Purdy1
1Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases (L.C.H., C.H.), Radiology and Imaging Sciences, Clinical Center (C.-Y.L., D.A.B.), Critical Care Medicine Department (J.B.P.), and National Institute of Diabetes and Digestive and Kidney Diseases (P.W.), National Institutes of Health, Bethesda Maryland 20892.
Insights
Individuals with HIV show increased heart disease risk due to abnormal lipid buildup. This study links higher lipolysis rates to increased intramyocardial lipid, suggesting lipolysis as a potential intervention target for heart health.
Area of Science:
- Cardiology
- Metabolism
- HIV Medicine
Background:
- Individuals with HIV have a higher risk of cardiovascular disease, often linked to abnormal lipid deposition.
- Dysregulation of lipolysis may contribute to lipid accumulation in non-adipose tissues like the heart, leading to adverse health outcomes.
Purpose of the Study:
- To investigate the relationship between whole-body lipolysis rates and intramyocardial lipid content in HIV-infected individuals compared to healthy controls.
Main Methods:
- A cross-sectional study was conducted at the National Institutes of Health Clinical Research Center.
- Forty-six HIV-infected adults and 12 healthy controls participated.
- Intramyocardial lipid content was measured using MRI, and lipolysis rates were determined via stable isotope tracer techniques.
Main Results:
- A significant positive correlation was found between the rate of glycerol appearance and intramyocardial lipid content overall and within the HIV group.
- Multivariate regression identified the rate of glycerol appearance and age as independent predictors of intramyocardial lipid.
- These associations were not significant when visceral adipose tissue was included in the analysis.
Conclusions:
- This study provides novel human data on the relationship between myocardial lipid deposition and whole-body fatty acid metabolism.
- Findings suggest that lipolysis is implicated in myocardial steatosis and may be a target for interventions to improve cardiac health in HIV patients.
Context:
Individuals with HIV have an elevated risk for developing cardiovascular disease compared to controls, particularly in relationship to abnormal deposition of lipid within various body compartments. Dysregulation of lipolysis may contribute to abnormal deposition of lipid in non-adipose tissues such as the heart, leading to untoward health consequences.
Objective:
To evaluate potential relationships between rates of whole-body lipolysis and intramyocardial lipid content in HIV-infected subjects compared to healthy controls.
Design:
Cross-sectional study.
Setting:
National Institutes of Health Clinical Research Center in Bethesda, Maryland.
Participants:
Forty-six HIV-infected adults and 12 controls without known cardiovascular disease.
Main Outcome Measure:
Intramyocardial lipid content quantified by MRI and rates of lipolysis determined using stable isotope tracer techniques.
Results:
We observed a significant positive correlation between the rate of appearance of glycerol and intramyocardial lipid overall (r = 0.323; P = .014) and among the HIV group separately (r = 0.361; P = .014). Multivariate regression analyses including HIV, lipid-lowering therapy, and diabetes identified both rate of appearance of glycerol and age as independent significant predictors of intramyocardial lipid (P = .01 and P = .03, respectively), but these were not significant with inclusion of visceral adipose in the analyses.
Conclusions:
To our knowledge, this study is among the first in humans to characterize the relationship between lipid deposition in the myocardium and direct measurement of whole-body fatty acid metabolism. Our current findings contribute to the growing understanding of factors that promote myocardial steatosis, such as visceral adiposity, and implicate lipolysis as a potential target for interventions to optimize myocardial health.
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