PDF(Pubmed)
Abstract：
UNASSIGNED: In the general population, it is established that adipose tissue depots pose various risks for cardiometabolic diseases. The interaction among obesity, HIV, and antiretroviral treatment promotes even greater risk for persons with HIV (PWH). As obesity is a heterogeneous condition, determining the specific obesity phenotypes present and their characteristics is critical to personalize care in PWH.
UNASSIGNED: Visceral, sarcopenic, myosteatotic, hepatosteatotic, and metabolically healthy obesity phenotypes were determined by pre-established cut points after segmentation of computed tomography scans at the L3 vertebra. Multivariable linear regression modeling included anthropometrics, clinical biomarkers, and inflammatory factors while controlling for age, sex, race, and body mass index (BMI).
UNASSIGNED: Of 187 PWH, 86% were male, and the mean ± SD age and BMI were 51.2 ± 12.3 years and 32.6 ± 6.3 kg/m2. Overall, 59% had visceral obesity, 11% sarcopenic obesity, 25% myosteatotic obesity, 9% hepatosteatotic obesity, and 32% metabolically healthy obesity. The strongest predictor of visceral obesity was an elevated triglyceride:high-density lipoprotein (HDL) ratio. Increased subcutaneous fat, waist circumference, and HDL cholesterol were predictors of sarcopenic obesity. Diabetes status and elevated interleukin 6, waist circumference, and HDL cholesterol predicted myosteatotic obesity. An increased CD4+ count and a decreased visceral:subcutaneous adipose tissue ratio predicted hepatosteatotic obesity, though accounting for only 28% of its variability. Participants with metabolically healthy obesity were on average 10 years younger, had higher HDL, lower triglyceride:HDL ratio, and reduced CD4+ counts.
UNASSIGNED: These findings show that discrete obesity phenotypes are highly prevalent in PWH and convey specific risk factors that measuring BMI alone does not capture. These clinically relevant findings can be used in risk stratification and optimization of personalized treatment regimens. This study is registered at ClinicalTrials.gov (NCT04451980).
UNASSIGNED: Visceral, sarcopenic, myosteatotic, hepatosteatotic, and metabolically healthy obesity phenotypes were determined by pre-established cut points after segmentation of computed tomography scans at the L3 vertebra. Multivariable linear regression modeling included anthropometrics, clinical biomarkers, and inflammatory factors while controlling for age, sex, race, and body mass index (BMI).
UNASSIGNED: Of 187 PWH, 86% were male, and the mean ± SD age and BMI were 51.2 ± 12.3 years and 32.6 ± 6.3 kg/m2. Overall, 59% had visceral obesity, 11% sarcopenic obesity, 25% myosteatotic obesity, 9% hepatosteatotic obesity, and 32% metabolically healthy obesity. The strongest predictor of visceral obesity was an elevated triglyceride:high-density lipoprotein (HDL) ratio. Increased subcutaneous fat, waist circumference, and HDL cholesterol were predictors of sarcopenic obesity. Diabetes status and elevated interleukin 6, waist circumference, and HDL cholesterol predicted myosteatotic obesity. An increased CD4+ count and a decreased visceral:subcutaneous adipose tissue ratio predicted hepatosteatotic obesity, though accounting for only 28% of its variability. Participants with metabolically healthy obesity were on average 10 years younger, had higher HDL, lower triglyceride:HDL ratio, and reduced CD4+ counts.
UNASSIGNED: These findings show that discrete obesity phenotypes are highly prevalent in PWH and convey specific risk factors that measuring BMI alone does not capture. These clinically relevant findings can be used in risk stratification and optimization of personalized treatment regimens. This study is registered at ClinicalTrials.gov (NCT04451980).
摘要：
■在一般人群中，已经确定脂肪组织储库对心脏代谢疾病有各种风险。肥胖之间的相互作用，艾滋病毒,抗逆转录病毒治疗会增加艾滋病毒感染者（PWH）的风险。由于肥胖是一种异质性疾病，确定存在的特定肥胖表型及其特征对于PWH的个性化护理至关重要.
■内脏，节瘤,肌肉骨质疏松,肝骨质疏松，和代谢健康的肥胖表型通过在L3椎骨的计算机断层扫描分割后预先建立的切割点确定。多变量线性回归模型包括人体测量学，临床生物标志物，和炎症因子，同时控制年龄，性别,种族,体重指数（BMI）。
■187PWH，86%是男性，平均±SD年龄和BMI为51.2±12.3岁和32.6±6.3kg/m2。总的来说,59%有内脏肥胖，11%的肌少症肥胖，25%的肌骨形成性肥胖,9％的肝骨性肥胖，和32%代谢健康的肥胖症.内脏肥胖的最强预测指标是甘油三酯：高密度脂蛋白（HDL）比值升高。皮下脂肪增加,腰围,高密度脂蛋白胆固醇和高密度脂蛋白胆固醇是肌少症性肥胖的预测因子。糖尿病状态与白细胞介素6、腰围、高密度脂蛋白胆固醇可预测肌肉骨质疏松性肥胖。增加的CD4+计数和减少的内脏：皮下脂肪组织的比例预测肝骨性肥胖，虽然只占其变异性的28%。代谢健康肥胖的参与者平均年轻10岁，HDL较高,较低的甘油三酯：HDL比率，和减少CD4+计数。
■这些发现表明，离散的肥胖表型在PWH中非常普遍，并且传达了单独测量BMI无法捕获的特定风险因素。这些临床相关发现可用于个性化治疗方案的风险分层和优化。本研究在ClinicalTrials.gov（NCT04451980）注册。
■内脏，节瘤,肌肉骨质疏松,肝骨质疏松，和代谢健康的肥胖表型通过在L3椎骨的计算机断层扫描分割后预先建立的切割点确定。多变量线性回归模型包括人体测量学，临床生物标志物，和炎症因子，同时控制年龄，性别,种族,体重指数（BMI）。
■187PWH，86%是男性，平均±SD年龄和BMI为51.2±12.3岁和32.6±6.3kg/m2。总的来说,59%有内脏肥胖，11%的肌少症肥胖，25%的肌骨形成性肥胖,9％的肝骨性肥胖，和32%代谢健康的肥胖症.内脏肥胖的最强预测指标是甘油三酯：高密度脂蛋白（HDL）比值升高。皮下脂肪增加,腰围,高密度脂蛋白胆固醇和高密度脂蛋白胆固醇是肌少症性肥胖的预测因子。糖尿病状态与白细胞介素6、腰围、高密度脂蛋白胆固醇可预测肌肉骨质疏松性肥胖。增加的CD4+计数和减少的内脏：皮下脂肪组织的比例预测肝骨性肥胖，虽然只占其变异性的28%。代谢健康肥胖的参与者平均年轻10岁，HDL较高,较低的甘油三酯：HDL比率，和减少CD4+计数。
■这些发现表明，离散的肥胖表型在PWH中非常普遍，并且传达了单独测量BMI无法捕获的特定风险因素。这些临床相关发现可用于个性化治疗方案的风险分层和优化。本研究在ClinicalTrials.gov（NCT04451980）注册。
