Fat distribution in HIV-infected patients reporting truncal enlargement quantified by whole-body magnetic resonance imaging

Engelson, Ellen S.; Kotler, Donald P.; Tan, YanXiu; Agin, Denise; Wang, Jack; Pierson, Richard N.; Heymsfield, Steven B.

doi:10.1093/ajcn/69.6.1162

Cited by 125 publications

(81 citation statements)

References 32 publications

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“…Total visceral (VAT) and subcutaneous adipose tissue (SAT) masses were measured using MRI-derived cross-sectional images of the total body, which involves the acquisition of ϳ40 axial images of 10-mm thickness at 40-mm intervals from head to toe (15,59). All MRI scans were analyzed by the same observer using image analysis software (sliceOmatic v. 4.0; TomoVision, Montreal, QC, Canada) on a Gateway PC (Gateway, North Sioux City, SD).…”

Section: Methodsmentioning

confidence: 99%

Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy

Johnson

Albu²,

Engelson³

et al. 2004

American Journal of Physiology-Endocrinology and Metabolism

125

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The lipodystrophy syndrome (adipose tissue redistribution and metabolic abnormalities) observed with highly active antiretroviral therapy (HAART) during human immunodeficiency virus (HIV) infection may be related to increased proinflammatory cytokine activity. We measured acute cytokine (TNF-α, IL-6, leptin), glycerol, and lactate secretion from abdominal subcutaneous adipose tissue (SAT), and systemic cytokine levels, in HIV-infected subjects with and without lipodystrophy (HIVL+ and HIVL–, respectively) and healthy non-HIV controls. Lipodystrophy was confirmed and characterized as adipose tissue redistribution in HIVL+ compared with HIVL– and controls, by dual-energy X-ray absorptiometry and by whole body MRI. TNF-α secretion from abdominal SAT and circulating levels of IL-6, soluble TNF receptors I and II, and insulin were elevated in HIVL+ relative to HIVL– and/or controls, particularly in HIVL+ undergoing HAART. In the HIV-infected group as a whole, IL-6 secretion from abdominal SAT and serum IL-6 were positively associated with visceral fat and were negatively associated with the relative amount of lower limb adipose tissue ( P < 0.01). Decreased leptin and increased lactate secretion from abdominal SAT were specifically associated with HAART. In conclusion, increased cytokine secretion from adipose tissue and increased systemic proinflammatory cytokine activity may play a significant role in the adipose tissue remodeling and/or the metabolic abnormalities associated with the HIV-lipodystrophy syndrome in patients undergoing HAART.

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Section: Methodsmentioning

confidence: 99%

Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy

Johnson

Albu²,

Engelson³

et al. 2004

American Journal of Physiology-Endocrinology and Metabolism

125

View full text Add to dashboard Cite

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“…Subjects had total body MRI scans (1.5 T, LX Signa, General Electric, Milwaukee, WI) at each measurement time. The programmed protocol obtained T1-weighted images (echo time ϭ 15 ms, repetition time ϭ 200 ms) as described in previous publications (5). Because the retroperitoneal membrane is not always identifiable on these images, subdivision of the IAAT compartment into OMAT and RPAT was achieved by drawing a line concatenating the nadirs of intraperitoneal organs and zeniths of retroperitoneal tissue such as anterior wall of the aorta, the psoas major muscle, or the kidneys and the posterior walls of the ascending and descending colon (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…A substantial proportion of human immunodeficiency virus (HIV)-infected individuals on highly active antiretroviral therapy (HAART) develop fat redistribution, or HIV lipodystrophy, which is characterized by increased IAAT and/or depletion of subcutaneous adipose tissue (3)(4)(5). It is believed that fat redistribution affects long-term health outcomes by exacerbating the associated metabolic alterations (9,12), which is a rationale for its treatment.…”

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confidence: 99%

Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy

Engelson

Albu³

et al. 2003

Journal of Applied Physiology

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. Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy. J Appl Physiol 94: 2051-2057, 2003; 10.1152/japplphysiol.00845.2002.-Lipodystrophy with increased intra-abdominal fat in human immunodeficiency virus (HIV) infection is common in the era of highly active antiretroviral therapy. It contributes to the metabolic derangements, as it does in non-HIVrelated conditions. Growth hormone administration reduces intra-abdominal fat content. This study compared the relative changes in omental-mesenteric (OMAT) and retroperitoneal adipose tissues (RPAT) during therapy with recombinant human growth hormone (rhGH) in HIVassociated lipodystrophy. Of 30 subjects who began rhGH therapy (6 mg/day), 25 completed 12 wk and 19 completed 24 wk. Fourteen subjects were followed for an additional 12 wk. Volumes of OMAT and RPAT were calculated from total body MRI scans and compared by paired t-tests. Both OMAT and RPAT significantly decreased after 12 and 24 wk of rhGH treatment (P Ͻ 0.001), but the reduction was more pronounced in OMAT than in RPAT (P Ͻ 0.001). Both OMAT and RPAT increased significantly (P Ͻ 0.001) after therapy was discontinued, but OMAT increased significantly more than did RPAT (122 vs. 37%, P Ͻ 0.001). There is preferential loss and regain of OMAT, compared with RPAT, in subjects with HIV-associated lipodystrophy undergoing growth hormone treatment.intra-abdominal adipose tissue; retroperitoneal adipose tissue; visceral adipose tissue; fat redistribution; body composition; human immunodeficiency virus INCREASED INTRA-ABDOMINAL ADIPOSE TISSUE (IAAT) has been linked to metabolic perturbations, especially hyperlipidemia and insulin resistance (21, 23), and reduction of intra-abdominal fat has been shown to improve insulin sensitivity in both animals (2) and humans (17,26). A substantial proportion of human immunodeficiency virus (HIV)-infected individuals on highly active antiretroviral therapy (HAART) develop fat redistribution, or HIV lipodystrophy, which is characterized by increased IAAT and/or depletion of subcutaneous adipose tissue (3-5). It is believed that fat redistribution affects long-term health outcomes by exacerbating the associated metabolic alterations (9, 12), which is a rationale for its treatment. Studies have shown that growth hormone secretion is suppressed in HIV-positive or HIV-negative subjects with increased IAAT (24, 25), and therapy with recombinant human growth hormone (rhGH) reduces IAAT contents (6,16,28). However, the effect of rhGH on relative changes of IAAT subcompartments has not been investigated.The IAAT compartment is complex and includes the retroperitoneal adipose tissue (RPAT) compartment, which is located posterior to the parietal peritoneal membrane, and the omental and mesenteric adipose tissue (OMAT) compartment, which includes the omentum, the serosal layer of the luminal gastrointestinal tract, and the mesentery. The anatomic differences between OMAT and RPAT are quite straightforward. In addition to their different...

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“…6,7 LD is routinely diagnosed either by physician's physical examination or by patient's self-report of body change, and these strategies have been regarded as valid in the context of epidemiological studies. [8][9][10] However, subjective perceptions of body change are not always consistent with the findings of imaging techniques, such as computed tomography (CT) and dual energy X-ray absorptiometry (DEXA), both regarded as the gold standard for diagnosing HIV-associated LD.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Sonographic Assessments and Clinical Questionnaire in the Diagnosis of HIV-Associated Lipodystrophy

Signorini

Netto

Gabbay

et al. 2011

Journal of the International Association of Physicians in AIDS

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The study evaluated the use of sonographic measurements as an alternative to assessments based on clinical or other imaging techniques for the diagnosis of body-fat abnormalities. The study enrolled 179 HIV-infected patients, 81 (45.3%) of them diagnosed as lipodystrophy (LD)-positive based on a clinical standard questionnaire. Association between clinical LD and sonographic measurements of face, right upper limb, subcutaneous abdomen, and visceral compartments was evaluated by multiple logistic regression. The predicted probability of the logistic model was 0.64, corresponding to a maximum sensitivity of 69.1% (58%-79%), a specificity of 94.9% (88%-98%), and to positive and negative predictive values of 92% (82%-97%) and 79% (70%-86%), respectively. Kappa measure of concordance was 65% (54%-77%). Low sensitivity poses a problem for the use of sonography to detect LD in the clinical routine as a single exam, speaking in favor of the combined use of clinical and sonographic measurements over time.

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Fat distribution in HIV-infected patients reporting truncal enlargement quantified by whole-body magnetic resonance imaging

Cited by 125 publications

References 32 publications

Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy

Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy

Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy

A Comparison of Sonographic Assessments and Clinical Questionnaire in the Diagnosis of HIV-Associated Lipodystrophy

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