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Independent Effects of Visceral Fat, Age and HIV Infection on Brain Structure .....'VAT(belly fat) associated with brain atrophy'
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Reported by Jules Levin
Presented at the 16th International Workshop on Co-morbidities and Adverse Drug Reactions in HIV 6 October 2014, Philadelphia USA
JE Lake1, WS Post2, TT Brown2, FJ Palella, Jr3, M Popov4, JT Becker4, the Metabolic and Neuropsychology Working Groups of the Multicenter
AIDS Cohort Study
1University of California Los Angeles, Los Angeles, CA, USA; 2Johns Hopkins University, Baltimore, MD, USA; 3Northwestern University, Chicago, IL, USA; 4University of Pittsburgh, Pittsburgh, PA, USA
from Jules: elevated significantly VAT associated with brain atrophy, so is age, diabetes, hypertension......program abstract: "suggesting the risk for CNS effects may be amplified in this population"
Program abstract:
Independent effects of visceral fat, age and HIV infection on brain structure
JE Lake1, WS Post2, TT Brown2, FJ Palella, Jr3, M Popov4, JT Becker4, the Metabolic and Neuropsychology Working Groups of the Multicenter
AIDS Cohort Study
1University of California Los Angeles, Los Angeles, CA, USA; 2Johns Hopkins University, Baltimore, MD, USA; 3Northwestern University, Chicago, IL, USA; 4University of Pittsburgh, Pittsburgh, PA, USA
Program abstract:
Background: HIV infection, obesity and elevated abdominal visceral fat (VAT) have been individually associated with changes in brain structure, but relationships between adiposity and brain structure in HIV-infected persons have not yet been described. We conducted a cross-sectional analysis of Multicenter AIDS Cohort Study (MACS) participants to determine associations between HIV serostatus, adiposity and brain structure.
Methods: We analysed data from 112 men (73 HIVinfected) in the MACS Cardiovascular 2 and Magnetic Resonance Imaging (MRI) sub-studies who underwent both VAT quantification by computed tomography and brain MRI. Structural MRIs were acquired using the ADNI MP-RAGE sequence. Voxel-based morphometry was used for brain volume analysis after preprocessing and controlling for intracranial volume.
Men were stratified by elevated (eVAT; ≥100 cm2) or 'normal' (nVAT; <100 cm2) abdominal VAT. Forward stepwise modelling was used to determine associations between vascular, obesity- and HIV-related variables and regional brain volume.
Results: Sixty-five percent of men had eVAT (mean 213.2 cm2 vs 62.3 cm2 nVAT). Age was similar between the groups, but eVAT men were more likely to be HIVinfected (75% vs 56% eVAT) and have hypertension, diabetes mellitus, body mass index (BMI)>25 kg/m2, smaller grey and white matter volumes and larger cerebrospinal fluid volume than nVAT men. Whole brain cerebrospinal fluid volume analysis found that hypertension, adiponectin, age, diabetes, BMI and eVAT were significantly associated with brain atrophy (P<0.05, in order of increasing strength of association). No associations were observed for HIV serostatus or related factors, nor were interactions between HIV and VAT, BMI or age. Physical activity level did not predict VAT area.
Additionally, greater age and VAT area were associated with smaller right superior temporal cortex (visual and auditory processing) volume, with the VAT effect predominating. Age effects were less extensive and focused in the caudate nucleus and ventral putamen (voluntary movement, learning, memory). VAT and age effects were overlapping and additive in the temporal neocortex (memory).
Conclusions: Traditional risk factors have greater effects on brain volume than HIV serostatus, with VAT having the strongest association. However, HIV-infected MACS men had disproportionately greater VAT, suggesting the risk for CNS effects may be amplified in this population. Whether interventions to reduce VAT will preserve brain volume and cognition in HIV-infected persons warrants investigation.
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