Changes in abdominal fat following antiretroviral therapy initiation in HIV-infected individuals correlate with waist circumference and self-reported changes

• Type of Material: Article
• Authors: Priya Bhagwat, University of California Los Angeles; Igho Ofotokun, Emory University; Grace A. McComsey, Case Western University; Todd T. Brown, Johns Hopkins University; Carlee Moser, Harvard University; Catherine A. Sugar, University of California Los Angeles; Judith S. Currier, University of California Los Angeles
• Language: English
• Date: 2017-03-01
• Publisher: International Medical Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 International Medical Press.
• Final Published Version (URL): http://dx.doi.org/10.3851/IMP3148
• Title of Journal or Parent Work: Antiviral Therapy
• ISSN: 1359-6535
• Volume: 22
• Issue: 7
• Start Page: 577
• End Page: 586
• Grant/Funding Information: This research was also supported by NIH grants HL095132, HL095126, AI069501, AI69471, and AI56933.; Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number UM1 AI068634, UM1 AI068636 and UM1 AI106701.
• Keywords: CARDIOVASCULAR-DISEASE RISK; RALTEGRAVIR; ACTG; VISCERAL ADIPOSE-TISSUE; Virology; ATAZANAVIR; WEIGHT; PREVALENCE; Science & Technology; Life Sciences & Biomedicine; CARDIOMETABOLIC RISK; BODY-COMPOSITION CHANGES; Infectious Diseases; MASS INDEX; Pharmacology & Pharmacy
• Research Categories: Biology, Biostatistics; Biology, Virology; Health Sciences, Public Health

Abstract

Background: We examined whether waist circumference (WC) and self-reported abdominal size changes can estimate visceral adipose tissue (VAT) changes for those initiating antiretroviral therapy (ART). Methods: Prospectively collected data from ACTG A5257 and its metabolic substudy, A5260s, were used for this analysis. ART-naive HIV-infected participants were randomized to one of three contemporary ART regimens. Changes in abdominal CT-measured VAT and total adipose tissue (TAT) and DXA-measured trunk fat were tested for association with WC changes (by Pearson correlation) and categories of self-reported abdominal size changes (by ANOVA) between entry and week 96. Linear models compared WC and self-reported changes. Results: The study population (n=328) was predominantly male (90%) and White non-Hispanic (44%) with a baseline median age of 36 years and body mass index of 25 kg/m 2 . At week 96, median WC change was +2.8 cm. Of those reporting at week 96, 53% indicated ‘no change/lost’, 39% ‘gained some/somewhat larger’ and 8% ‘gained a lot/much larger’ as their self-reported changes. Trunk fat, VAT and TAT changes differed across self-reported groups (ANOVA P < 0.0001 for all), and the group ordering was as expected. WC changes were strongly correlated with CT and DXA changes (trunk fat: r=0.72, p < 0.0001; VAT: r=0.52, p < 0.0001; TAT: r=0.62, p < 0.0001). While WC changes explained a greater proportion of VAT, TAT and trunk fat variation, self-reported changes remained a significant predictor after controlling for WC (p < 0.05). Conclusions: WC and self-reported abdominal changes each correlated directly with imaging-derived abdominal fat measures, and can be used as reliable, affordable tools for central adiposity assessment.