Histological and Molecular Adipose Tissue Changes Are Related to Metabolic Syndrome Rather Than Lipodystrophy in Human Immunodeficiency Virus-Infected Patients: A Cross-Sectional Study. (17th May 2018)

• Record Type: Journal Article
• Authors: Langkilde, Anne; Tavenier, Juliette; Danielsen, Allan Vestergaard; Eugen-Olsen, Jesper; Therkildsen, Christina; Jensen, Frank Krieger; Henriksen, Jens Henrik; Langberg, Henning; Steiniche, Torben; Petersen, Janne; Holck, Susanne; Andersen, Ove
• Is Part Of: Journal of infectious diseases. Volume 218:Number 7(2018)
• Page Start: 1090
• Page End: 1098
• Publication Date: 2018-05-17
• Subjects: adipose tissue -- HIV-infection -- lipodystrophy -- metabolic syndrome; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiy284
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: In human immunodeficiency virus (HIV)-infected patients on combination antiretroviral therapy (cART), lipodystrophy shares many similarities with metabolic syndrome, but only metabolic syndrome has objective classification criteria. We examined adipose tissue changes related to lipodystrophy and metabolic syndrome to clarify whether it may be acceptable to focus diagnosis on metabolic syndrome rather than lipodystrophy. Methods: This is a cross-sectional study of 60 HIV-infected men on cART and 15 healthy men. We evaluated lipodystrophy (clinical assessment) and metabolic syndrome (JIS-2009). We compared adipocyte size, leukocyte infiltration, and gene expression in abdominal subcutaneous adipose tissue biopsies of patients with and without lipodystrophy and with and without metabolic syndrome. Results: Lipodystrophy was only associated with increased macrophage infiltration ( P = .04) and adiponectin messenger ribonucleic acid ([mRNA] P = .008), whereas metabolic syndrome was associated with larger adipocytes ( P < .0001), decreased expression of genes related to adipogenesis and adipocyte function ( P values between <.0001 and .08), increased leptin mRNA ( P = .04), and a trend towards increased expression of inflammatory genes ( P values between .08 and .6). Conclusions: Metabolic syndrome rather than lipodystrophy was associated with major unfavorable abdominal subcutaneous adipose tissue changes. In a clinical setting, it may be more relevant to focus on metabolic syndrome diagnosis in HIV-infected patients on cART with regards to adipose tissue dysfunction and risk of cardiometabolic complications. Abstract : In HIV-infected patients on newer combination antiretroviral therapy, metabolic syndrome rather than lipodystrophy was associated with unfavorable changes in abdominal subcutaneous adipose tissue, thus diagnosis of metabolic syndrome may be more relevant to assess adipose tissue dysfunction.