445. Adiponectin Levels and Coronary Artery Disease among HIV-Infected Men
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • adiponectin pdf.pdf (2.5 MB)
  • Background: Heart disease is a leading cause of mortality among HIV patients. Metabolic changes, including lipodystrophy, may contribute to the excess risk of coronary artery disease (CAD).  However, the association of adipose-related hormones, such as adiponectin, and CAD among HIV patients remains unclear.

    Methods: We performed a cross-sectional study of HIV-infected men to evaluate the association of adiponectin levels and CAD as measured by coronary artery calcium (CAC) scores.  CAC scores were categorized as no detectable disease, minimum disease (1-100), and significant disease (>100).  Adiponectin levels were determined by multimeric enzyme-linked immunosorbent immunoassay (ALPCO Diagnostics) at Brigham and Women's Laboratory.  Multivariate logistic regression modeling was performed to assess the association of adiponectin levels and CAC scores.

    Results: 213 HIV-infected men were evaluated with a median age of 43 years, 51% were Caucasian, median CD4 count of 583 cells/mm3, and 69% had a HIV RNA<50 copies/mL. Fifty-one percent had lipohypertrophy by visual assessment, 30% had hypertension, and 6% had diabetes.  Thirty-three percent (n=71) had a positive CAC score, of which 8% had a CAC>100.  The median adiponectin level was 3.1 µg/ml (95% CI 2.8-3.3).  Seventy percent (n=149) had a low adiponectin level (<4 µg/ml), including 66% with a CAC=0, 76% with a CAC of 1-100, and 81% with a CAC>100.  Adiponectin levels were inversely correlated with lipohypertrophy, hypertension, and triglyceride levels (p<0.05).  In the final multivariate model, increasing age (OR 3.82 per 10 year increase, 95% CI 2.56-5.71, p<0.001) was significantly associated with CAC, and adiponectin had a borderline association (OR 0.83 per 1 mg increase, 95% CI 0.69-1.00, p=0.05).  Similar associations were noted between adiponectin and increased vascular aging (p=0.10) and Framingham Risk Score (0.07).    

    Conclusion:  Low adiponectin levels are common among HIV-infected persons.  Adiponectin is correlated with lipohypertrophy, and lower levels had a borderline association with CAD in our study.  Understanding the precise role of adiponectin in the pathogenesis of cardiovascular disease may lead to development of more targeted preventive and treatment strategies for HIV patients.


    Subject Category: H. HIV/AIDS and other retroviruses

    Louise Norton1, Stephanie Brodine, MD1, Sheila Medina, MPH2,3, Hector Lemus, PhD1, Vincent Ricchiuti, PhD4, Gilbert Boswell, MD2 and Nancy Crum-Cianflone, MD MPH1,2,3, (1)San Diego State University, San Diego, CA, (2)Naval Medical Center San Diego, San Diego, CA, (3)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (4)Brigham and Women's Hospital Laboratory and Harvard Medical School, Boston, MA

    Disclosures:

    L. Norton, None

    S. Brodine, None

    S. Medina, None

    H. Lemus, None

    V. Ricchiuti, None

    G. Boswell, None

    N. Crum-Cianflone, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.