Case Western Reserve University, Cleveland, Ohio, USA.
Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
HIV Med. 2024 Feb;25(2):233-244. doi: 10.1111/hiv.13566. Epub 2023 Oct 16.
The role of body fat on metabolic complications remains poorly understood in young people living with perinatally acquired HIV (YPHIV).
Our objective was to assess the association of changes in adiposity over 2 years with metabolic outcomes in YPHIV.
The PHACS Adolescent Master Protocol (AMP) study enrolled YPHIV from 2007 to 2009 across 15 US sites, including Puerto Rico. We included YPHIV aged 7-19 years with body composition data assessed by whole-body dual-energy X-ray absorptiometry (DXA) at baseline and 2 years later. Metabolic outcomes included homeostatic model assessment of insulin resistance (HOMA-IR) and non-high-density lipoprotein cholesterol (non-HDL-C). We fitted linear regression models to assess the association of increase in body fat over 2 years with metabolic outcomes at years 2 and 3.
In all, 232 participants had a second DXA and either HOMA-IR or non-HDL-C measured at year 2. Participant characteristics at the first DXA were: age 12 years (9-14) [median (Q1-Q3)], 69% Black, and median CD4 count 714 cells/μL; 70% with HIV RNA <400 copies/mL. In adjusted analyses for every 1% increase in body fat from baseline to year 2, HOMA-IR was higher by 1.03-fold at year 3 (95% CI: 1.00, 1.05). We observed that for every 1% increase in body fat from baseline to year 2, non-HDL-C was 0.72 mg/dL higher at year 2 (95% CI: -0.04-1.49) and 0.81 mg/dL higher at year 3 (95% CI: -0.05-1.66).
Increases in adiposity over time may lead to downstream decreased insulin sensitivity and dyslipidaemia in YPHIV.
在感染艾滋病毒的年轻人（YPHIV）中，体脂对代谢并发症的作用仍知之甚少。
我们的目的是评估在 2 年内脂肪量变化与 YPHIV 代谢结果的相关性。
PHACS 青少年综合研究方案（AMP）研究于 2007 年至 2009 年在 15 个美国地点（包括波多黎各）招募了 YPHIV。我们纳入了 YPHIV，年龄为 7-19 岁，在基线和 2 年后使用全身双能 X 射线吸收仪（DXA）评估身体成分数据。代谢结果包括稳态模型评估的胰岛素抵抗（HOMA-IR）和非高密度脂蛋白胆固醇（非-HDL-C）。我们拟合线性回归模型来评估 2 年内体脂增加与第 2 年和第 3 年代谢结果的相关性。
共有 232 名参与者进行了第二次 DXA 检查，其中 2 人在第 2 年测量了 HOMA-IR 或非-HDL-C。第一次 DXA 时参与者的特征为：年龄 12 岁（9-14）[中位数（Q1-Q3）]，69%为黑人，中位 CD4 计数为 714 个细胞/μL；70%的 HIV RNA<400 拷贝/mL。在调整分析中，从基线到第 2 年，体脂每增加 1%，第 3 年 HOMA-IR 增加 1.03 倍（95%CI：1.00，1.05）。我们观察到，从基线到第 2 年，体脂每增加 1%，第 2 年非-HDL-C 增加 0.72mg/dL（95%CI：-0.04-1.49），第 3 年增加 0.81mg/dL（95%CI：-0.05-1.66）。
随着时间的推移，脂肪量的增加可能导致 YPHIV 的胰岛素敏感性降低和血脂异常。
