Srinivasa Suman, Lu Michael T, Fitch Kathleen V, Hallett Travis R, O'Malley Timothy K, Stone Lauren A, Martin Amanda, Coromilas Alexandra J, Burdo Tricia H, Triant Virginia A, Lo Janet, Looby Sara E, Neilan Tomas G, Zanni Markella V
Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Antivir Ther. 2018;23(1):1-9. doi: 10.3851/IMP3193.
Mechanisms underlying the heightened myocardial infarction risk among HIV-infected women (versus non-HIV-infected women) remain unclear. Our objectives were to assess epicardial adipose tissue (EAT) volume and its associations among asymptomatic women with and without HIV.
A total of 55 HIV-infected and 27 non-HIV-infected women without known cardiovascular disease who underwent cardiac CT and metabolic/immune phenotyping were included. EAT volume derived from CT was compared among women with and without HIV, and within-group EAT associations were assessed. Next, immune and atherosclerotic plaque parameters were compared among groups stratified by HIV serostatus and high/low EAT (defined in reference to median EAT for each serostatus group).
Asymptomatic HIV-infected women and age-matched non-HIV-infected women with comparable mean body mass index (28 ±1 versus 29 ±1 kg/m) had similar median (IQR) volumes of EAT (54 [41-79] versus 65 [41-78] cm; P>0.05); however, different within-group associations were noted. Markers of monocyte activation/arterial inflammation differed by HIV serostatus/EAT volume subgroup (CXCL10 [P=0.02], sCD163 [P=0.004], sCD14 [P=0.03], Lp-PLA [P=0.04]; P for overall ANOVA) and were highest among HIV-infected women with excess EAT (versus HIV-infected women without excess EAT, non-HIV-infected women with excess EAT and non-HIV-infected women without excess EAT). The percentage of segments with non-calcified coronary plaque also differed by HIV serostatus/EAT volume subgroup and was highest among HIV-infected women with excess EAT.
Asymptomatic women with and without HIV have similar volumes of EAT, but drivers of EAT may differ between groups. HIV-infected women with excess EAT have highest-level immune activation and the highest percentage of non-calcified plaque. Future studies are needed to determine whether EAT contributes pathogenetically to HIV-associated cardiovascular disease in women.
HIV感染女性（相对于未感染HIV的女性）中心肌梗死风险升高的潜在机制尚不清楚。我们的目标是评估无症状HIV感染和未感染HIV的女性的心外膜脂肪组织（EAT）体积及其相关性。
纳入了55名感染HIV和27名未感染HIV且无已知心血管疾病的女性，她们接受了心脏CT检查以及代谢/免疫表型分析。比较了感染HIV和未感染HIV的女性的CT衍生EAT体积，并评估了组内EAT相关性。接下来，比较了按HIV血清学状态和高/低EAT分层的组（根据每个血清学状态组的EAT中位数定义）之间的免疫和动脉粥样硬化斑块参数。
无症状的HIV感染女性和年龄匹配的未感染HIV女性，平均体重指数相当（分别为28±1和29±1kg/m²），EAT的中位数（IQR）体积相似（分别为54[41-79]和65[41-78]cm³；P>0.05）；然而，观察到不同的组内相关性。单核细胞活化/动脉炎症标志物因HIV血清学状态/EAT体积亚组而异（CXCL10[P=0.02]、sCD163[P=0.004]、sCD14[P=0.03]、Lp-PLA[P=0.04]；总体方差分析的P值），在EAT过多的HIV感染女性中最高（相对于EAT不过多的HIV感染女性、EAT过多的未感染HIV女性和EAT不过多的未感染HIV女性）。非钙化冠状动脉斑块节段的百分比也因HIV血清学状态/EAT体积亚组而异，在EAT过多的HIV感染女性中最高。
有无HIV感染的无症状女性EAT体积相似，但不同组间EAT的驱动因素可能不同。EAT过多的HIV感染女性免疫激活水平最高，非钙化斑块百分比最高。未来需要开展研究以确定EAT是否在发病机制上导致女性HIV相关心血管疾病。
