749
Factors Associated with Regional Adipose Tissue in HIV+ Women
Phyllis Tien*1,2, P Bacchetti1, J Cofrancesco3, S Heymsfield4, and FRAM Study
1Univ of California, San Francisco, US; 2VAMC, San Francisco, CA, US; 3Johns Hopkins Univ, Baltimore, MD, US; and 4Merck, Rahway, NJ, US
Background:
Peripheral fat loss and central fat gain have been reported in HIV+
women, but linkage has not been proven. We determined factors associated with
subcutaneous adipose tissue depots and visceral adipose tissue.
Methods: Cross-sectional
analysis of MRI-measured regional adipose tissue volumes in 338 HIV+
women from the study of fat redistribution and metabolic change in HIV
infection.
Results: Mean age was 41±8.2 years and body mass index 27;
55% were African American, 33% Caucasian. HIV disease represented the full
spectrum (mean CD4 407). The table shows factors associated with subcutaneous and
visceral adipose tissue. Physical
activity was associated with less subcutaneous adipose tissue depots and
visceral adipose tissue; age with more visceral
adipose tissue. Duration of stavudine use was associated with less leg, lower trunk,
and upper trunk subcutaneous adipose tissue, but not more visceral adipose tissue. Lamivudine was associated with more visceral
adipose tissue; indinavir
with more upper trunk subcutaneous adipose tissue depots; and didanosine
with more lower trunk subcutaneous adipose tissue depots. Other associations with ART individually,
by class of HAART did not appear important after adjusting for ART that reached
significance.
|
|
Leg
|
Lower Trunk
|
Upper Trunk
|
Visceral Adipose Tissue
|
|
|
%
Effect
|
95%CI*
|
% Effect
|
95%CI
|
% Effect
|
95%CI
|
% Effect
|
95% CI
|
|
|
|
Ethnicity
(reference: Caucasian)
|
|
|
|
|
|
|
|
|
|
African American
|
24
|
(7, 51)
|
2
|
(–12, 19)
|
–4
|
(–18, 13)
|
–41
|
(–53, –24)
|
|
Hispanic
|
1
|
(–26, 32)
|
16
|
(–7, 46)
|
26
|
(–0, 62)
|
4
|
(–31, 52)
|
|
Other
|
–1
|
(–35, 32
|
–5
|
(–53, 43)
|
14
|
(–32, 70)
|
15
|
(–56, 123)
|
|
Age (per decade)
|
–1
|
(–9, 7)
|
2
|
(–7, 10)
|
8
|
(–1, 17)
|
26
|
(6,43)
|
|
Current smoker
|
0
|
(–13, 20)
|
–8
|
(–20, 8)
|
–8
|
(–21, 6)
|
–20
|
(–36, 1)
|
|
Physical activity
(reference: 1st Quartile)
|
|
|
|
|
|
|
|
|
|
2nd Quartile
|
1
|
(–15, 17)
|
0
|
(–13, 17)
|
–1
|
(–14, 17)
|
–8
|
(–27, 14)
|
|
3rd Quartile
|
–14
|
(–39, 13)
|
–8
|
(–28, 16)
|
–8
|
(–30, 19)
|
–28
|
(–52, 5)
|
|
4th Quartile
|
–27
|
(–46, –6)
|
–25
|
(–43, –2)
|
–22
|
–47, 6)
|
–37
|
(–59, –6)
|
|
Current HIV RNA
|
–2
|
(–10, 7)
|
–7
|
(–16, 1)
|
–6
|
(–15, 2)
|
–6
|
(–19, 9)
|
|
Current CD4
|
–4
|
(–9, 2)
|
0
|
(–6, 6)
|
1
|
(–6, 6)
|
5
|
(–6, 18)
|
|
ART reaching significance
(per year of use)
|
|
|
|
|
|
|
|
|
|
Stavudine
|
–10
|
(–14, –7)
|
–7
|
(–10, –4)
|
–3
|
(–7, 0)
|
–2
|
(–8, 4)
|
|
Lamivudine
|
–3
|
(–7, 1)
|
0
|
(–4, 4)
|
2
|
(–2, 6)
|
7
|
(1, 13)
|
|
Didanosine
|
6
|
(–1, 14)
|
8
|
(2, 15)
|
2
|
(–5, 10)
|
7
|
(–5, 18)
|
|
Indinavir
|
0
|
(–5, 7)
|
3
|
(–1, 9)
|
6
|
(1, 12)
|
1
|
(–7, 8)
|
|
*CI = confidence interval
|
Conclusions: Different
factors are associated with different adipose tissue volumes in HIV+
women. Stavudine
was associated with less subcutaneous fat, but not more visceral adipose
tissue. Lamivudine was associated with more visceral adipose
tissue, and indinavir with more upper trunk subcutaneous
adipose tissue depots, but these effects were weaker than physical activity and
age.
|
