Histological and Molecular Adipose Tissue Changes are related to Metabolic Syndrome rather than Lipodystrophy in HIV-infected Patients-A Cross-Sectional Study

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Background: In 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: 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=0.04) and adiponectin mRNA (P=0.008), whereas metabolic syndrome was associated with larger adipocytes (P<0.0001), decreased expression of genes related to adipogenesis and adipocyte function (P-values between <0.0001-0.08), increased leptin mRNA (P=0.04), and a trend towards increased expression of inflammatory genes (P-values between 0.08-0.6).

Conclusions: Metabolic syndrome rather than lipodystrophy was associated with major unfavourable 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 cardio-metabolic complications.

Original languageEnglish
JournalThe Journal of Infectious Diseases
Issue number7
Pages (from-to)1090-1098
Number of pages9
Publication statusPublished - 2018

ID: 199387226