在接受高效抗逆转录病毒治疗相关代谢综合征的HIV感染患者中，心外膜脂肪组织与颈动脉内膜中层厚度及内脏肥胖有关。

Epicardial adipose tissue is related to carotid intima-media thickness and visceral adiposity in HIV-infected patients with highly active antiretroviral therapy-associated metabolic syndrome.

作者信息

Iacobellis Gianluca, Sharma Arya M, Pellicelli Adriano M, Grisorio Benvenuto, Barbarini Giorgio, Barbaro Giuseppe

机构信息

Cardiovascular Obesity Research and Management at the Michael G deGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

出版信息

Curr HIV Res. 2007 Mar;5(2):275-9. doi: 10.2174/157016207780077084.

DOI:10.2174/157016207780077084

PMID:17346142

Abstract

BACKGROUND

High cardiovascular risk and accelerated atherosclerosis are associated with human immunodeficiency virus (HIV). Recently, the use of highly active antiretroviral therapy (HAART) for the treatment of HIV infection is correlated with the development of HAART-associated metabolic syndrome and lipodystrophy (LDS). Detection of epicardial fat thickness, new index of visceral adiposity in non HIV-infected patients, might be important as diagnostic tool in HIV-infected patients on HAART.

OBJECTIVE

Primary objective of this study was to evaluate whether echocardiographic epicardial adipose tissue is related to visceral adipose tissue (VAT) and Carotid Intima-Media Thickness (IMT), index of atherosclerosis in HIV-infected patients on HAART with LDS.

DESIGN

We studied 60 consecutive HIV-infected subjects with HAART-associated metabolic syndrome and LDS and 45 HIV-infected subjects on HAART without LDS.

MAIN OUTCOMES MEASURES

Epicardial fat thickness and IMT were measured by ultrasonography in both study and control groups. Magnetic resonance imaging (MRI) was used to calculate VAT in HIV-infected subjects on HAART with LDS.

RESULTS

Epicardial adipose tissue thickness showed an excellent correlation with MRI-VAT (r=0.85; P<0.001) and IMT (r=0.78;P<0.001) in HIV-infected patients on HAART-with LDS. Multiple regression analysis showed that epicardial fat thickness was best predicted by MRI-VAT and IMT (R2=0.57, p<0.001 and p<0.01, respectively). HIV-infected patients with HAART-associated metabolic syndrome and LDS showed higher epicardial fat thickness and IMT (8 vs 6.5 mm; 0.71 vs 0.66 mm, respectively, p<0.01 for both) than HIV-infected subjects on HAART without LDS.

CONCLUSION

Echocardiographic assessment of epicardial fat may have the potential to be a simple and reliable marker of visceral adiposity and increased cardiovascular risk in HIV-infected patients with HAART-associated metabolic syndrome and LDS.

摘要

背景

高心血管风险和加速动脉粥样硬化与人类免疫缺陷病毒（HIV）有关。最近，使用高效抗逆转录病毒疗法（HAART）治疗HIV感染与HAART相关代谢综合征和脂肪代谢障碍（LDS）的发生相关。检测心外膜脂肪厚度（非HIV感染患者内脏脂肪增多的新指标），对于接受HAART治疗的HIV感染患者可能是一种重要的诊断工具。

目的

本研究的主要目的是评估超声心动图检测的心外膜脂肪组织是否与内脏脂肪组织（VAT）及颈动脉内膜中层厚度（IMT）相关，后者是患有LDS的接受HAART治疗的HIV感染患者动脉粥样硬化的指标。

设计

我们研究了60例连续的患有HAART相关代谢综合征和LDS的HIV感染受试者以及45例接受HAART治疗但无LDS的HIV感染受试者。

主要观察指标

在研究组和对照组中均通过超声测量心外膜脂肪厚度和IMT。使用磁共振成像（MRI）计算患有LDS的接受HAART治疗的HIV感染受试者的VAT。

结果

在患有LDS的接受HAART治疗的HIV感染患者中，心外膜脂肪组织厚度与MRI-VAT（r=0.85；P<0.001）和IMT（r=0.78；P<0.001）具有极好的相关性。多元回归分析表明，MRI-VAT和IMT对心外膜脂肪厚度的预测效果最佳（R2分别为0.57、p<0.001和p<0.01）。患有HAART相关代谢综合征和LDS的HIV感染患者的心外膜脂肪厚度和IMT高于接受HAART治疗但无LDS的HIV感染受试者（分别为8 vs 6.5 mm；0.71 vs 0.66 mm，两者p均<0.01）。