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Independent associations of insulin resistance with high whole-body intermuscular and low leg subcutaneous adipose tissue distribution in obese HIV-infected women^1,2,3

¹ From the Endocrine, Diabetes and Nutrition Division and the New York Obesity Research Center (JBA, MW, ESB, and SH) and Gastrointestinal Division (SK, QH, DPK, and ESE), St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY

Background: Obesity and insulin resistance are growing problems in HIV-positive (HIV+) women receiving highly active antiretroviral therapy (HAART).

Objective: The objective was to determine the contribution of adipose tissue (AT) enlargement and distribution to the presence of insulin resistance in obese HIV+ women.

Design: Whole-body intermuscular AT (IMAT), visceral AT (VAT), subcutaneous AT (SAT), and SAT distribution (leg versus upper body) were measured by whole-body magnetic resonance imaging. Insulin sensitivity (S_I) was measured with an intravenous glucose tolerance test in obese HIV+ women recruited because of their desire to lose weight (n = 17) and in obese healthy controls (n = 32).

Results: The HIV+ women had relatively less whole-body SAT and more VAT and IMAT than did the controls (P < 0.05 for all). A significant interaction by HIV status was observed for the relation of total SAT with S_I (P < 0.001 for the regression's slope interactions after adjustment for age, height, and weight). However, relations of IMAT, VAT, and SAT distribution (leg SAT as a percentage of total SAT; leg SAT%) with S_I did not differ significantly between groups. For both groups combined, the best model predicting a low S_I included significant contributions by both high IMAT and low leg SAT%, independent of age, height, and weight, and no interaction between groups was observed (overall r² = 0.44, P = 0.0003).

Conclusion: In obese HIV+ women, high whole-body IMAT and low leg SAT% distribution are independently associated with insulin resistance.

Key Words: Subcutaneous adipose tissue • intermuscular adipose tissue • adipose tissue distribution • insulin resistance • HIV infection

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Adipose compartmentalization and insulin resistance among obese HIV-infected women: the role of intermuscular adipose tissue

Tisha Joy and Steven K Grinspoon
AJCN 2007 86: 5-6. [Full Text]  

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