Sonographically measured perirenal fat thickness: An early predictor of atherosclerosis in HIV‐1‐infected patients receiving highly active antiretroviral therapy?

BackgroundHuman immunodeficiency virus (HIV) infection and antiretroviral treatment are associated with metabolic and cardiovascular complications that potentially increase the risk of atherosclerosis and cardiovascular disease in this population. Measurement of arterial wall thickness has been used as a surrogate of extent, severity and progression of atherosclerosis. A cross-sectional cohort study was performed to compare the validity of two non-invasive arterial measures: carotid intima-media thickness (IMT), a parameter of atherosclerosis, and ophthalmic artery resistance index (OARI), an index of occlusive carotid artery disease.MethodsA total of 95 patients receiving highly active antiretroviral therapy (HAART) for more than 12 months were consecutively enrolled. IMT and OARI were measured by 7.5 MHz linear probe.ResultsThere was a significant linear increase in IMT and OARI values as the grade of cardiovascular risk (0.70 and 0.69 for very low risk, 0.86 and 0.72 for low risk and 0.98 and 0.74 for medium/high risk, p < 0.001). A IMT > 0.83 and an OARI > 0.72 were the most discriminatory values for predicting a cardiovascular risk ≥ 10% (sensibility 89.6% and 75.8%; sensitivity 70.5% and 68.4%; p < 0.001).ConclusionsOur data indicate that OARI may have a potential as a new precocious marker of subclinical atherosclerosis in HIV-1-infected patients.

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“…Moreover, as previously demonstrated, we had low intra-observer variability for IMT ultrasonographic measurements [16,30]…”

Section: Discussionmentioning

confidence: 58%

Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients

Grima¹,

Guido

Chiavaroli³

et al. 2011

Cardiovasc Ultrasound

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“…However, several studies postulated that not only PRAT has a pronounced role in regulating kidney function but is also associated with cardiometabolic risk factors. Clinical studies suggest that excess PRAT is associated with higher risk of CVDs (423,424). The weight of PRAT has the highest partial correlation coefficient with CVDs among other AT (425).…”

Section: Perirenal Adipose Tissuementioning

confidence: 98%

Adipose Tissue Immunomodulation: A Novel Therapeutic Approach in Cardiovascular and Metabolic Diseases

AlZaim

Hammoud

Al-Koussa

et al. 2020

Front. Cardiovasc. Med.

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Adipose tissue is a critical regulator of systemic metabolism and bodily homeostasis as it secretes a myriad of adipokines, including inflammatory and anti-inflammatory cytokines. As the main storage pool of lipids, subcutaneous and visceral adipose tissues undergo marked hypertrophy and hyperplasia in response to nutritional excess leading to hypoxia, adipokine dysregulation, and subsequent low-grade inflammation that is characterized by increased infiltration and activation of innate and adaptive immune cells. The specific localization, physiology, susceptibility to inflammation and the heterogeneity of the inflammatory cell population of each adipose depot are unique and thus dictate the possible complications of adipose tissue chronic inflammation. Several lines of evidence link visceral and particularly perivascular, pericardial, and perirenal adipose tissue inflammation to the development of metabolic syndrome, insulin resistance, type 2 diabetes and cardiovascular diseases. In addition to the implication of the immune system in the regulation of adipose tissue function, adipose tissue immune components are pivotal in detrimental or otherwise favorable adipose tissue remodeling and thermogenesis. Adipose tissue resident and infiltrating immune cells undergo metabolic and morphological adaptation based on the systemic energy status and thus a better comprehension of the metabolic regulation of immune cells in adipose tissues is pivotal to address complications of chronic adipose tissue inflammation. In this review, we discuss the role of adipose innate and adaptive immune cells across various physiological and pathophysiological states that pertain to the development or progression of cardiovascular diseases associated with metabolic disorders. Understanding such mechanisms allows for the exploitation of the adipose tissue-immune system crosstalk, exploring how the adipose immune system might be targeted as a strategy to treat cardiovascular derangements associated with metabolic dysfunctions.

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“…Fewer studies have related perirenal fat to CVD. In adults, higher perirenal fat was related to multiple risk factors for metabolic disease [25], including high blood pressure in overweight subjects [9] and atherosclerosis in patients with human immunodeficiency virus (HIV) [10]. Perirenal fat was also considered to be a proxy for visceral obesity in adult subjects [26].…”

Section: Ectopic Fat and Cvdmentioning

confidence: 99%

“…Among visceral adipose tissue deposits, those located around the kidneys are regarded as metabolically active tissue that secretes pro-inflammatory cytokines, which in turn exert both local and systemic effects on the vasculature [7,8]. The association of perirenal fat thickness with hypertension [9] and atherosclerosis [10] has been described in adult patients.…”

Section: Introductionmentioning

confidence: 99%

Perirenal and epicardial fat and their association with carotid intima-media thickness in children

López‐Bermejo

Prats‐Puig

Osiniri

et al. 2019

Ann Pediatr Endocrinol Metab

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Recent data suggest that subclinical atherosclerosis is more related to visceral adipose tissue distribution than to overall fat mass. Both perirenal fat and epicardial fat are visceral fat depots surrounding the kidneys and the myocardium, respectively, which can be easily assessed by ultrasound. Their clinical relevance in children is largely unknown. This review describes studies relating perirenal and epicardial fat to cardiovascular disease or carotid intima-media thickness (cIMT), a well-established surrogate for subclinical atherosclerosis, and discusses this in context with our own data from children. In adults, both perirenal and epicardial fat are useful biological markers of visceral obesity. The former has been related to hypertension in overweight subjects and with atherosclerosis in patients with human immunodeficiency virus. The latter was associated with several metabolic syndrome components and with calcification of the carotid artery. In healthy prepubertal children, both epicardial and perirenal fat thickness, rather than total body fat mass, were related to cIMT. Ultrasonography measures of perirenal and epicardial fat are related to atherosclerosis in adults and may be convenient tools for the assessment of cardiometabolic risk in children.

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Sonographically measured perirenal fat thickness: An early predictor of atherosclerosis in HIV‐1‐infected patients receiving highly active antiretroviral therapy?

Abstract: Our data demonstrated that PRFT measurement could be used as an early predictor of IMT increase in HIV-1-infected patients receiving highly active antiretroviral therapy.

Cited by 24 publications

References 34 publications

Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients

Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients

Adipose Tissue Immunomodulation: A Novel Therapeutic Approach in Cardiovascular and Metabolic Diseases

Perirenal and epicardial fat and their association with carotid intima-media thickness in children

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