Revista de SIDA e investigación clínica

Adiponectin Levels and Coronary Artery Disease among HIV-Infected Men

Abstract

Louise Norton, Stephanie K Brodine, Sheila Medina, Hector Lemus, Vincent Ricchiuti, Gilbert Boswell, Dylan Wessman, David Krause and Nancy F Crum-Cianflone

Objective: HIV-infected persons frequently experience lipodystrophy and are at higher risk of cardiovascular disease, but the impact of adipose-related hormones, such as adiponectin, on Coronary Artery Disease (CAD) remains unclear. We evaluated the association of plasma adiponectin levels and the presence of CAD.

Design: A cross-sectional study among HIV-infected men in a large HIV clinic. Methods: HIV-infected participants underwent CT scan imaging to determine CAD as measured by Coronary Artery Calcium (CAC) scores categorized as no detectable disease (0), minimum disease (1-100), and significant disease (>100). Factors associated with CAD, including adiponectin levels, were evaluated using multivariate logistic regression modeling.

Results: 213 HIV-infected men were evaluated with a median age of 43 years, median CD4 count of 583 cells/ mm3, and 69% had HIV RNA<50 copies/mL. Forty-nine percent had lipohypertrophy, 30% had hypertension, and 21% had a moderate/high Framingham risk score (FRS). Thirty-three percent (n=71) had positive CAC scores. Seventy percent (n=149) had a low adiponectin level (<4.0 μg/ml), including 66% with CAC=0, 76% with CAC of 1-100, and 81% with CAC>100 (p=0.09). Adiponectin levels were inversely correlated with lipohypertrophy, hypertension, and triglyceride levels (p<0.05), while FRS was marginally correlated (X2=3.1, p=0.08). In the final multivariate model, increasing age (OR 3.8 per 10 year increase, 95% CI 2.56-5.71, p<0.001) was significantly associated with CAC, and adiponectin approached significance (OR 0.8 per 1 μg/ml increase, 95% CI 0.69-1.00, p=0.05).

Conclusions: Low adiponectin levels are common among HIV-infected persons. Adiponectin is correlated with lipohypertrophy and lower levels approached significance with CAD. Understanding the role of adiponectin in the pathogenesis of CAD may allow for targeted treatment and prevention strategies among HIV-infected persons.