The Associations of Regional Adipose Tissue With Lipid and Lipoprotein Levels in HIV-Infected Men.

BACKGROUND:: HIV infection and antiretroviral therapy are associated with dyslipidemia, but the association between regional adipose tissue depots and lipid levels is not defined. METHODS:: The association of magnetic resonance imaging- measured visceral adipose tissue (VAT) and regional subcutaneous adipose tissue (SAT) volume with fasting lipid parameters was analyzed by multivariable linear regression in 737 HIV-infected and 145 control men from the study of Fat Redistribution and Metabolic Change in HIV Infection. RESULTS:: HIV-infected men had higher median triglycerides (170 mg/dL vs. 107 mg/dL; P < 0.0001), lower high-density lipoprotein cholesterol (HDL-C; 38 mg/dL vs. 46 mg/dL; P < 0.0001), and lower low-density lipoprotein cholesterol (LDL-C; 105 mg/dL vs. 125 mg/ dL; P < 0.0001) than controls. After adjustment, greater VAT was associated with higher triglycerides and lower HDL-C in HIV-infected and control men, whereas greater leg SAT was associated with lower triglycerides in HIV-infected men with a similar trend in controls. More upper trunk SAT was associated with higher LDL-C and lower HDL-C in controls, whereas more lower trunk SAT was associated with higher triglycerides in controls. After adjustment, HIV infection remained strongly associated (P < 0.0001) with higher triglycerides (+76%, 95% confidence interval [CI]: 53 to 103), lower LDL-C (219%, 95% CI: 225 to 212), and lower HDL-C (218%, 95% CI: 222 to 212). CONCLUSIONS:: HIV-infected men are more likely than controls to have higher triglycerides and lower HDL-C, which promote atherosclerosis, but also lower LDL-C. Less leg SAT and more VAT are important factors associated with high triglycerides and low HDLC in HIV-infected men. The reduced leg SAT in HIV-infected men with lipoatrophy places them at increased risk for proatherogenic dyslipidemia.

Wohl D, Scherzer R, Heymsfield S, Simberkoff M, Sidney S, Bacchetti P, Grunfeld C; the FRAM Study Investigators.

From the *AIDS Clinical Trials Unit, University of North Carolina, Chapel Hill, NC; †Northern California Institute for Research and Education, San Francisco, CA; ‡Merck Inc., Rahway, NJ; §Veterans Affairs Medical Center, New York Harbor Healthcare System, New York, NY; ∥Division of Research, Kaiser Permanente, Oakland, CA; {Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; #Department of Veterans Affairs Medical Center, San Francisco, CA; and the **Department of Medicine, University of California, San Francisco, San Francisco, CA.