P-453. Cardiovascular Risk Scores and Insulin Resistance are Higher with Excess Visceral Abdominal Fat in People with HIV in the Modern Antiretroviral (ART) Era
Notice bibliographique
Résumé
Abstract Background People with HIV (PWH) are at an increased risk of cardiovascular disease (CVD), even after accounting for traditional risk factors like diabetes and dyslipidemia. Metabolic syndrome, a component of which is central adiposity, is also increasingly prevalent in PWH. Yet, there are few data on the contribution of excess visceral abdominal fat (EVAF) to increased CVD risk in PWH in the modern ART era. Methods We used the Visceral Adiposity Measurement and Observation Study (VAMOS) to investigate how EVAF impacts traditional CVD risk factors and overall CV risk in PWH. VAMOS is a cross-sectional, multi-center observational study in PWH, virologically suppressed for ≥1 year, with BMI ranging from 20 to 40 kg/m2. Participants completed study visits, labs, and an abdominal computed tomography scan in the overnight fasting state. Visceral fat was quantified by a single slice at L4-L5. Growth hormone (GH) levels, HOMA-IR and triglyceride:high-density lipoprotein (TG:HDL) ratios (an alternative measure of insulin resistance, IR) were also analyzed. Relationships with EVAF were assessed by Spearman correlation coefficients and Wilcoxon Two-Sample Tests (EVAF defined as ≥130 cm2). Results Of the 170 participants studied, the majority were white and male with an average age of 54 years. Median visceral fat area was 148 cm2 (94, 218) with an EVAF prevalence of 58%. Participants with EVAF had higher HOMA-IR values (p≤.0001) and higher TG:HDL ratios (p=0.0013) than those without EVAF. There was also a positive correlation between EVAF and HOMA-IR (ρ=0.43, p≤0.0001) and TG:HDL ratio (ρ=0.33, p≤0.0001). Importantly, greater visceral fat area was associated with higher 10-year ASCVD risk (p< 0.0001). To understand a potential driver behind this relationship between EVAF and CV risk, GH levels were explored. Increasing visceral fat surface area was inversely correlated with GH levels (ρ=-0.17, p=0.03); moreover, there were lower GH levels in subjects with EVAF (p=0.05). Conclusion Increased levels of visceral fat relate to increased CV risk scores, as well as the traditional risk factors of IR and lipid levels, which contributes to the heightened risk of CVD in PWH on modern ART regimens. The dynamics between decreased GH levels and EVAF found here support targeting EVAF reduction via the GH axis. Disclosures Karam Mounzer, MD, Epividian: Board Member|Epividian: Honoraria|GS: Advisor/Consultant|GS: Grant/Research Support|GS: Honoraria|Merck: Advisor/Consultant|THERA Technologies: Grant/Research Support|ViiV healthcare: Advisor/Consultant|ViiV healthcare: Grant/Research Support|ViiV healthcare: Honoraria John R. Koethe, MD, Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Merck & Co.: Advisor/Consultant|Merck & Co.: Grant/Research Support Jordan Lake, MD, Merck: Advisor/Consultant|Theratechnologies: Advisor/Consultant Mohammed Zogheib, PharmD, MPH, Theratechnologies: Employee Colleen McGary, PhD, Theratechnologies: Employee R Brandon Cash, PharmD, Theratechnologies: Employee
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».