Abstract P229: Pericardial Fat Density is Associated With Insulin Resistance in Treated HIV Infection: The SATURN-HIV Trial
Objective: To examine associations of pericardial fat (PCF) volume and density with baseline and changes in insulin resistance among HIV+ subjects participating in a trial of statin therapy.
Methods: SATURN-HIV was a 96-week double-blind, randomized trial of 10 mg daily rosuvastatin versus placebo among 147 HIV+ subjects on stable antiretroviral therapy with LDL-c ≤130mg/dL and evidence of heightened T-cell activation or increased inflammation (high sensitivity C-reactive protein ≥2mg/L). PCF volume (ml) and density (mean Hounsfield Units) were measured from coronary calcium CT scans at entry. Homeostatic model of insulin resistance (HOMA-IR) was calculated from insulin and glucose at entry, 24, 48, and 96 weeks. Pearson correlations and linear mixed modeling were used to explore relationships between PCF and insulin resistance.
Results: Median (Q1, Q3) age was 46 (40, 53) years; 78% were male and 68% African American; 49% were on a protease inhibitor. Median HOMA-IR was 1.84 (1.06, 3.33) at baseline, and participants randomized to statin had larger 0-96 week mean percentage increase in HOMA-IR (+73% vs +33%, statin vs placebo, p=0.009). PCF density did not correlate with measures of total body adiposity (BMI r=0.057 and total body fat r=-0.034, both p>0.4), but was negatively correlated to waist-hip ratio (-0.337, p<0.001). In a linear mixed model, PCF density was associated with baseline HOMA-IR independent of PCF volume, BMI, metabolic syndrome, and biomarkers of immune activation and systemic inflammation; however, PCF density was not associated with longitudinal changes in HOMA-IR (see Table).
Conclusions: Coronary calcium scans are widely used to assess cardiovascular risk and appropriateness of statin therapy. In this HIV+ population, PCF density, a simple measure obtained from these scans, appears to be a novel marker of insulin resistance that is independent of PCF volume. Larger, adequately powered studies are needed to determine if PCF density predicts development of insulin resistance on statin.
Author Disclosures: C.T. Longenecker: None. Y. Liu: None. M. Schlucter: None. G.A. McComsey: B. Research Grant; Modest; Bristol-Myers Squibb, Gilead, Glaxo-Smith Kline. D. Speakers Bureau; Modest; Bristol-Myers Squibb, Merck. G. Consultant/Advisory Board; Modest; Bristol-Myers Squibb, Gilead, Glaxo-Smith Kline. H. Other; Modest; Pfizer.
- © 2015 by American Heart Association, Inc.