Vol.72 No.1 January 2024
Clinical features of visceral fat obesity in men infected with human immunodeficiency virus on antiretroviral therapy
1)Center for Health Control, Nara Medical University, 840 Shijo, Kashihara, Nara, Japan
2)Center for Infectious Diseases, Nara Medical University
3)Department of Infectious Diseases, Minami-Nara General Medical Center
4)Department of Pharmacy, Nara Medical University Hospital
Abstract
Weight gain and obesity in individuals infected with human immunodeficiency virus (HIV) are attracting attention. Instead of simply measuring the body weight in such patients, evaluation of the visceral fat area (VFA) is important in these patients. Therefore, we measured the VFA in HIV-infected individuals with a visceral fat-measuring device (DUALSCAN®) based on the principle of dual-bioelectrical impedance analysis (BIA), to investigate the clinical features of visceral fat obesity.
VFA was measured at the level of the umbilicus in 61 HIV-infected men (median age: 46 years) in whom the viral loads were kept below 20 copies/mL by antiretroviral therapy. The patients were divided into those with VFA ≥100 cm2 (visceral obesity) and those with VFA <100 cm2 (normal), and the following anthropometric parameters were compared between the two groups: body fat percentage (BIA), presence or absence of comorbidities (i.e., hypertension, dyslipidemia, diabetes mellitus, fatty liver, and metabolic syndrome), difference in pulse wave velocity (PWV) from the mean age-adjusted value (⊿PWV), plasma oxidative stress levels, and plasma antioxidant capacity.
The median VFA was 78.0 cm2, and 20 of them (32.8%) had visceral fat obesity. No significant difference was observed in the mean age, distribution of the HIV infection stage, or CD4-positive cell count between the two groups. The body mass index, waist circumference, and body fat percentage were significantly higher in the visceral obesity group. There was a significant correlation between the VFA and the waist circumference. In the visceral obesity group, the prevalences of underlying diseases such as hypertension, dyslipidemia, diabetes mellitus, fatty liver, and metabolic syndrome were significantly higher, and the ⊿PWV and oxidative stress levels were also significantly higher. The prevalences of hypertension, dyslipidemia, and fatty liver were significantly higher in the patients who were not receiving tenofovir alafenamide than in those who were. The prevalences of underlying hypertension and metabolic syndrome were significantly higher in the patients with a history of treatment with protease inhibitors.
Since HIV-infected individuals with visceral obesity often have metabolic complications and advanced arteriosclerosis, attention should be paid to the VFA and waist circumference in HIV-infected individuals. Some antiretroviral drugs, lifestyle habits, and oxidative stress may be involved in the pathology of visceral fat obesity in HIV-infected individuals.
Key word
human immunodeficiency virus, visceral fat obesity, metabolic syndrome, antiretroviral therapy
Received
January 31, 2023
Accepted
September 4, 2023
Jpn. J. Chemother. 72 (1): 1-8, 2024
