Journal Article

CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy

Moser, Carlee, Nelson, Scott D, Johnston, Liz, McComsey, Grace A, Lake, Jordan E, Magyar, Clara, Brown, Todd T, Erlandson, Kristine M

2019

Overview

Abstract Context Microscopic measurement of adipocyte size is the gold standard for determining adipose tissue (AT) quality. AT density on CT may also reflect adipocyte quality (lower density = poorer quality). Objective We used abdominal subcutaneous AT (SAT) specimens and CT scans to validate CT SAT density as a marker of SAT quality in adults living with HIV. Setting and Design Secondary data analysis from completed trial of antiretroviral therapy (ART) initiation (ACTG A5224s). CT abdominal SAT density was measured in HU. SAT specimens were digitally scanned for calculation of mean adipocyte area. Participants Participants had SAT biopsy and CT data at baseline (n = 54) and HIV-1 RNA <50 copies per milliliter on ART and biopsy or CT data at week 96 (n = 30). Outcome Measures Spearman correlations and linear regression models adjusting for participant characteristics examined associations between SAT density and adipocyte area. Results Baseline median age was 40 years, CD4+ T lymphocyte count 219 cells per cubic millimeter, and body mass index 26.0 kg/m2; 89% were male and 67% white. Median SAT area and density were 199 cm2 and −100 HU. Over 96 weeks, SAT area increased (+18%) and SAT density decreased (−3%). Mean SAT adipocyte area correlated with SAT density (P < 0.01) off and on ART after adjustment for SAT area, age, race, sex, CD4+ T lymphocyte count, and HIV-1 RNA. Conclusions CT SAT density correlates with biopsy-quantified SAT adipocyte size in adults with HIV on and off ART, suggesting that CT is a useful tool for noninvasive assessment of SAT quality. In adults living with HIV on and off antiretroviral therapy, CT subcutaneous fat density measurement reflects histologic adipocyte size and can be used as a noninvasive measure of adipocyte function.

• Publisher: Endocrine Society,Copyright Oxford University Press,Oxford University Press
• Subject: Adipocytes / Adipose tissue / Adipose Tissue - diagnostic imaging / Adipose Tissue - metabolism / Adipose Tissue - pathology / Adipose tissues / Adult / Adults / Analysis / Anti-Retroviral Agents - therapeutic use / Antiretroviral drugs / Antiretroviral therapy / Atazanavir / Biological products industry / Biopsy / Body Fat Distribution / Body mass index / CD4 antigen / Cell number / Clinical s / CT imaging / Diagnostic imaging / Drug therapy / Efavirenz / Emtricitabine / Female / Highly active antiretroviral therapy / HIV / HIV Infections - diagnosis / HIV Infections - drug therapy / HIV Infections - metabolism / HIV Infections - pathology / HIV-Associated Lipodystrophy Syndrome - diagnosis / HIV-Associated Lipodystrophy Syndrome - metabolism / HIV-Associated Lipodystrophy Syndrome - pathology / Human immunodeficiency virus / Humans / Information management / Lymphocytes T / Male / Middle Aged / Quality / Regression analysis / Ribonucleic acid / RNA / Subcutaneous Fat - diagnostic imaging / Subcutaneous Fat - metabolism / Subcutaneous Fat - pathology / Subcutaneous Fat, Abdominal - diagnostic imaging / Subcutaneous Fat, Abdominal - pathology / T cells / Tomography, X-Ray Computed