Fat Redistribution Predicts Cardiac Risk Women with HIV

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Fat Redistribution Predicts Cardiac Risk in Women with HIV

By Megan Rauscher

Relatively young HIV-infected women have significant abnormalities in "critical" cardiovascular risk markers, including C-reactive protein (CRP), and changes in these markers relate directly to changes in fat redistribution, e.g. increased truncal and visceral adiposity.

These are the findings of Dr. Steven Grinspoon, from Harvard Medical School and Massachusetts General Hospital in Boston and colleagues, which are reported in the May 1st issue of the Journal of Acquired Immune Deficiencies Syndrome.

"Metabolic abnormalities are seen increasingly in HIV-infected women, but the relationship to cardiovascular risk markers has remained largely unknown," Dr. Grinspoon told Reuters Health.

He and colleagues investigated cardiovascular risk markers in 100 HIV-infected women and 75 healthy women of similar age, weight, and racial background.

The HIV-infected population demonstrated significantly higher CRP (4.6 vs 2.3 mg/L), interleukin-6 (2.7 vs 1.8 pg/mL), triglyceride (1.84 vs 0.85 mM), 2-hour glucose after oral glucose challenge (6.88 vs 5.72 mM), and fasting insulin (81 vs 45 pM).

They also displayed significantly lower HDL-cholesterol (1.17 vs 1.45 mM) and adiponectin (5.4 vs 7.6 mg/L) compared with the control population.

Body composition studies showed that the HIV-infected population had more abdominal visceral fat and less extremity fat and demonstrated a higher waist-to-hip ratio compared with the healthy controls.

In stepwise regression models, CRP and other indices were significantly related to body composition in the HIV-infected population.

These data suggest that changes in fat redistribution have implications for cardiovascular health and highlight "the importance of monitoring for cardiovascular disease in HIV-infected women," Dr. Grinspoon noted.

"Simple markers of increased truncal adiposity, such as the waist-to-hip ratio, are highly predictive of increased CRP and other cardiovascular risk markers," he added.

05/27/05

J Acquir Immune Defic Syndr 2005;39:44-54.