Nutritional Status and Lipid Profile in HIV-Infected Adults

Abstract

In the last decades, there have been many reports of HIV infection and abnormalities in lipid metabolism and cardiovascular disease (CVD). This study aims at describing the nutritional status of HIV-infected adults and its relation to lipid profile through traditional [total cholesterol (TC), HDL cholesterol (HDL), triglycerides (TG), non-HDL cholesterol and LDL cholesterol (LDL)] and other parameters [Apolipoprotein B (ApoB), fibrinogen, and high sensitive-C-reactive protein (hs-CRP)]. A cross-sectional descriptive study was performed. Body mass index (BMI) was calculated and references were taken from WHO. TC, HDL, TG and glucose were determined and non-HDL cholesterol and LDL were calculated. ApoB and fibrinogen were determined by quantitative radial immunodiffusion on agar plates (Diffuplate,Biocientífica SA,Argentina) and hs-CRP by immunoturbidimetric test. Qualitative variables were compared with the Chi-square test or Fisher's exact test. Quantitative variables were compared applying parametrics or nonparametric tests. Pearson test for correlations. Software SPSS 17.0. 97 patients were analyzed: 69.1% were men. 80% were on antiretroviral treatment. Average (SD) BMI was 24.3 (4.1) kg/m(2). 29.4% were overweight and 5.9% obese. Patients with a BMI ≥25.0 kg/m(2) presented significantly higher levels of TG, ApoB and glycemia than well-nourished people [246.1(169.0) vs. 142.9(78.4) mg/dL;p=0.029, 198.6(69.3) vs. 126.4(50.6) mg/dL;p=0.01 and 100 (3.2) vs. 90.2 (6.9) mg/dL;p=0.008 resp.] and a significantly decreased HDL [37.2(1.5) vs. 49.8(10.4) mg/dL;p<0.01]. No statistically significant correlation was found between ApoB and non-HDL (p=0,063). There was no evidence that there is a direct relation between Apo B and the other lipid parameters. The potential increase in CVD in this group of patients, would be related to the higher levels of TG, ApoB and overweight/obesity. Nutritional education is needed to promote a healthy weight to warn against the risk of cardiovascular disease.

The Fat of the Matter: Obesity and Visceral Adiposity in Treated HIV Infection

“…The development of comorbid disease in HIV-infected persons is believed to have both traditional and HIV-/ART-specific contributors: Obesity, and particularly VAT accumulation, are associated with systemic[12, 47] and adipose tissue inflammation[48], insulin resistance, dyslipidemia[49] and increased oxidative stress[50]. At the same time, adipose tissue is a potential HIV reservoir, leading to recruitment of T lymphocytes and macrophages into adipose tissue.…”

Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection

“…Obesity likely has similar metabolic and inflammatory consequences in HIV-infected persons as in the general population (Figure 1). Obesity and lipohypertrophy, particularly VAT accumulation, are often associated with chronic inflammation in adipose tissue, insulin resistance [51][52][53][54], increased metabolic syndrome risk [55], dyslipidemia [56] and increased oxidative stress [57]; abdominal obesity is robustly associated with cardiovascular disease (CVD) risk and mortality [58][59][60]. However, for any given BMI, HIV infection appears to confer greater Poorer neurocognitive function was associated with increased waist circumference (WC) among HIV-infected participants in the CHARTER study [25].…”

Brief Report: Relationship Between Adiposity and Biomarkers of Aging and Frailty Among Adults Aging With HIV

“…In agreement with studies that demonstrated an increasing prevalence of obesity among PWH, 13 we observed increased adiposity measured by standard BMI criteria (ie, BMI $ 25 kg/m 2 ) and waist circumference, which are associated with numerous metabolic and inflammatory effects among PWH, having implications for morbidity and mortality. [29][30][31][32] The relationship between abdominal adiposity and adipokines may be exacerbated in PWH because ART toxicity can alter the hemostatic regulation of adipokines. 33 In our study, increased abdominal adiposity was associated with higher levels of hsCRP, which appears central in both adiposity-and sarcopenia-associated inflammation.…”