In HIV, Focus on Adipose Tissue Changes

In patients with HIV who are taking combination antiretroviral therapy (cART), metabolic syndrome is a better predictor for adipose dysfunction and cardiometabolic complications than is lipodystrophy, according to a new study.

For their study, the researchers examined abdominal subcutaneous adipose tissue biopsies from 60 HIV-infected men taking cART and 15 healthy men. 

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The researchers evaluated lipodystrophy via clinical assessment and metabolic syndrome via JIS-2009 classification. Adipocyte size, leukocyte infiltration, and gene expression in the biopsies were compared among patients with vs without lipodystrophy and with vs without metabolic syndrome.

Compared with lipodystrophy, metabolic syndrome was associated with larger adipocytes, lower gene expression related to adipogenesis and adipocyte function, higher leptin macrophage infiltration and adiponectin messenger ribonucleic acid (mRNA), and a trend toward increased expression of inflammatory genes.

Lipodystrophy was only associated with increased mRNA.

“Metabolic syndrome rather than lipodystrophy was associated with major unfavorable abdominal subcutaneous adipose tissue changes,” the researchers concluded.

“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.”

—Amanda Balbi

Reference:

Langkilde A, Tavenier J, Vestergaard Danielsen A, et al. Histological and molecular adipose tissue changes are related to metabolic syndrome rather than lipodystrophy in human immunodeficiency virus-infected patients: a cross-sectional study. J Infect Dis. 2018;218(7):1090-1098. https://doi.org/10.1093/infdis/jiy284.