Ultrasound-assessed perirenal fat is related to increased ophthalmic artery resistance index in HIV-1 patients

Abstract

BackgroundThe introduction of highly active antiretroviral therapy (HAART) has dramatically changed the prognosis of human immunodeficiency virus (HIV) infection, with a significant decline in morbidity and mortality.Changes in body fat distribution are a common finding in individuals with HIV infection being treated with antiretrovirals, and this condition (collectively termed lipodystrophy syndrome) is associated with depletion of subcutaneous fat, increased triglycerides and insulin resistance. Obesity, particularly visceral obesity, is associated with increased risk of cardiovascular disease. Therefore, estimating visceral fat distribution is important in identifying subjects at high risk for cardiovascular disease.The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a parameter of central obesity, is related to ophthalmic artery resistance index (OARI), an index of occlusive carotid artery disease in HIV-1 infected patients.MethodsWe enrolled 88 consecutive HIV-1-infected patients receiving highly active antiretroviral therapy for more than 12 months, in a prospective cohort study. Echographically measured PRFT and OARI, as well as serum metabolic parameters, were evaluated. PRFT and OARI were measured by 3.75 MHz convex and 7.5 MHz linear probe, respectively.ResultsThe means of PRFT and OARI in HIV-1-infected patients with visceral obesity was considerably higher than in patients without it (p < 0.0001 and p < 0.001, respectively). Using the average OARI as the dependent variable, total serum cholesterol level, HDL, triglycerides, glycemia, sex, blood pressure, age and PRFT were independent factors associated with OARI. A PRFT of 6.1 mm was the most discriminatory value for predicting an OARI > 0.74 (sensitivity 78.9%, specificity 82.8%).ConclusionsOur data indicate that ultrasound assessment of PRFT may have potential as a marker of increased endothelial damage with specific involvement of the ocular vascular region in HIV-1-infected patients.

Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients

“…Moreover, as previously demonstrated, we had low intra-observer variability for IMT ultrasonographic measurements [16,30]…”

Increased ophthalmic artery resistance index is associated with cognitive impairment in HIV-infected patients

“…13 Recent data show that increased carotid intima-media thickness (cIMT), a subclinical marker of atherosclerosis, predicts cognitive decline in memory and executive function 14,15 in agreement with the hypothesis that subjects with cognitive impairment can exhibit pathological arterial wall changes. 16 It is also known that OARI provides additional hemodynamic information for the assessment of cardiovascular disease severity in HIV-1-infected patients 8,17 with potential advantages over cIMT measurement. 13 The purpose of this study was to investigate the potential relationship between subclinical cerebrovascular disease assessed by OARI measurement and the development of mild neurocognitive disorders in a cohort of HIV-1-infected patients.…”

“…7 The ophthalmic artery is a branch of the internal carotid and changes in its blood flow can provide insights into cerebral vascular diseases such as carotid artery stenosis and metabolic disorders. 8,9 It has been demonstrated that measuring orbital vessel velocity may be useful for evaluating the distal consequences of carotid obstructive diseases. 10 Pathological ophthalmic artery resistance index (OARI) seems to reflect diminished arterial compliance caused by systemic atherosclerosis 9 and hemodynamically significant lesion distal to carotid artery bifurcation.…”

Visceral fat in different locations assessed by ultrasound: Correlation with computed tomography and cut‐off values in patients with metabolic syndrome

“…The US method of VAT quantification is especially attractive compared to other ones due to the absence of radiation, its low cost and ample availability. A number of US techniques have been proposed for measuring VAT in different locations 12‐24 . A close correlation between US and CT values in visceral fat has been established through the majority of US techniques.…”