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Association of Upper Trunk and Visceral Adipose Tissue Volume With Insulin Resistance in Control and HIV-Infected Subjects in the FRAM Study
Open accessAbstract
Visceral obesity is associated with insulin resistance, but the association of other regional adipose depots with insulin resistance is not understood. In HIV infection, buffalo hump (upper trunk fat) is associated, but the association of upper trunk fat with insulin resistance has not been examined in controls. To determine the independent association of adipose depots other than visceral with insulin resistance, we performed a cross-sectional analysis of controls and HIV-infected subjects in the Fat Redistribution and Metabolic Change in HIV Infection (FRAM) study, who had measurements of glucose, insulin, and adipose tissue volumes by whole-body magnetic resonance imaging. We studied 926 HIV-positive persons from 16 academic medical center clinics and trials units with demographic characteristics representative of US patients with HIV infection and 258 FRAM controls from the population-based Coronary Artery Risk Development in Young Adults study. We measured visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) volume in the legs, arms, lower trunk (back and abdomen), and upper trunk (back and chest) and assessed their association with the homeostasis model of assessment (HOMA) and HOMA >4 by stepwise multivariable analysis. The prevalence of HOMA >4 as a marker of insulin resistance was 28% among controls compared with 37% among HIV-infected subjects (P = 0.005). Among controls, those in the highest tertile of upper trunk SAT volume had an odds ratio (OR) of 9.0 (95% confidence interval [CI]: 2.4 to 34; P = 0.001) for having HOMA >4 compared with the lowest tertile, whereas in HIV-positive subjects, the OR was lower (OR = 2.09, 95% CI: 1.36 to 3.19; P = 0.001). Among controls, the highest tertile of VAT volume had an OR of 12.1 (95% CI: 3.2 to 46; P = 0.0002) of having HOMA >4 compared with the lowest tertile, whereas in HIV-positive subjects, the OR was 3.12 (95% CI: 2.0 to 4.8; P < 0.0001). After adjusting for VAT and upper trunk SAT, the association of other SAT depots with HOMA >4 did not reach statistical significance. Thus, VAT and upper trunk SAT are independently associated with insulin resistance in controls and in HIV-infected persons.
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“Patients with HIV are also affected by antiretroviral-associated lipodystrophy and visceral obesity that can further contribute to inflammation and cause insulin resistance137.”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [137]
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“Given recent evidence that upper trunk as well as visceral fat is associated with increased insulin resistance [64] and leg fat is associated with lower metabolic risk [65, 66], we also examined the overall change in ratio of total trunk to leg fat as an index of relative body fat distribution.”
BackgroundAgeing and inflammation in patients with HIV infection
Nasi, M., De Biasi, S., Gibellini, L., Bianchini, E., Pecorini, S., Bacca, V, Guaraldi, G., Mussini, C., Pinti, M., & Cossarizza, A. (2016) · Clinical and Experimental Immunology · doi:10.1111/cei.12814 · Cited by 277
Metadata
- Authors
- Grunfeld, C., Rimland, D., Gibert, C. L., Powderly, W. G., Sidney, S., Shlipak, M. G., Bacchetti, P., Scherzer, R., Haffner, S. M., & Heymsfield, S. B.
- Affiliations
- United States Department of Veterans Affairs (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- University College Dublin (IE)
- Kaiser Permanente (US)
- San Francisco VA Medical Center (US)
- University of California, San Francisco (US)
- Corresponding author
- Scherzer, Rebecca
- ORCID
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2007-11-01
- Volume
- 46
- Issue
- 3
- Pages
- 283-290
- ISSN
- 1525-4135 (ISSN-L)
- PMC
- PMC3164883
- OpenAlex
- W2066979644
- Cited by
- 114
- References
- 52
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 8 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 8 · 2014: 7 · 2013: 6 · 2012: 15
- FWCI
- 10.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2m01rr000083-41)
- National Heart, Lung, and Blood Institute (HL-53359, R01HL053359, HL-74814, R01HL074814)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK57508, R01DK057508)
- National Center for Research Resources (M01 RR-00052, M01 RR-00054, M01RR-00051, M01 RR 00083, M01-RR00036, (M01 RR00865), M01RR000054, M01RR000051, M01RR000052, M01-RR000083, M01RR000865, M01-RR0636, M01RR000036)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- visceral adipose tissue, subcutaneous adipose tissue, HIV infection, buffalo hump, visceral obesity, HOMA-IR, body fat distribution, Coronary Artery Risk Development in Young Adults Study, whole-body MRI, adipose tissue volume
- MeSH terms
- Adipose Tissue, Adult, Female, Homeostasis, Humans, Insulin Resistance, Male, Middle Aged, Models, Biological, Reference Values, Regression Analysis, Risk Factors, Thorax, Viscera, HIV Infections
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