Teressa Sumy Thomas, MD

Pronouns

She/Her/Hers

Rank

Research Fellow

Institution

MGH

BWH-MGH Title

Department

Medicine

Authors

*Teressa S. Thomas, *Sanjna Iyengar, *Grace Shen, *Allie R. Walpert, *Gail K. Adler, *Steven K. Grinspoon, *Suman Srinivasa

Visceral adiposity index as a measure of cardiometabolic disease in persons living with HIV

WMSS 2022

I am a specialist physician and the recipient of the prestigious Discovery MGH Fellowship from South Africa, currently doing a research fellowship at MGH. This fellowship gives opportunity to early- to mid-career physicians, with preference to Black Economic Empowerment (BEE) and has been a wonderful experience and truly a blessing.

This vision of uplifting groups that have not been previously favored embodies the same principle as Women in Medicine, which resonates with me. My special research interests include the HIV/endocrine interface. Persons with HIV are a group that I want to apply my skills to uplift through high quality research.

Background

Well-treated persons living with HIV (PLWH) are predisposed to accumulation of visceral-adipose-tissue (VAT), an inflamed and dysfunctional ectopic fat depot, and demonstrate 2-fold higher cardiovascular disease (CVD) risk compared to those without HIV. Gold-standard measures of VAT by CT and MRI are not used clinically. The visceral-adiposity-index (VAI) is a simple tool combining biochemical measures with anthropometrics in a sex-specific formula.

Methods

45 virological-controlled PLWH without known CVD and an abdominal VAT area>110cm² on CT were included. Coronary plaque was measured using CT-angiography or PET scans. Linear regression was performed to assess relationships with VAI.

Results

Participants [male(73%), Caucasian(53%), non-Hispanic(84%) and age 55±7 years] were obese (BMI 31.9±5.8kg/m²) with VAT 189[127,267]cm² and VAI 4.9[2.8,7.3]. VAI correlated strongly with VAT (r=0.59, P<0.0001), anthropometric measures (BMI r=0.36, P=0.02; WC r=0.43, P=0.004; WHR r=0.33, P=0.03) and ALT (r=0.32, P=0.03). Participants with coronary plaque tended to have a higher VAI compared to those without (log-VAI 0.7±0.3 vs. 0.5±0.3, P=0.056).

Conclusion

These data show VAI strongly correlates with abdominal VAT area and may be a useful biomarker for visceral adiposity in HIV. Furthermore, VAI may relate to ALT and coronary plaque, helping identify those PLWH at risk for fatty liver and heart disease, respectively.