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.
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.
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).
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.