Sonographically Measured Perirenal Fat Thickness: An Early Predictor of Atherosclerosis in HIV-1-Infected Patients Receiving Highly Active Antiretroviral Therapy?

Purpose. The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a parameter of central obesity, is related to carotid intimamedia thickness (IMT), an index of atherosclerosis in human immunodeficiency virus (HIV)-1-infected patients.

Methods. We enrolled 70 consecutive HIV-1-infected patients receiving highly active antiretroviral therapy for more than 12 months, in a prospective cohort study. Sonographically measured PRFT and carotid IMT, as well as serum metabolic parameters, were evaluated. PRFT and IMT were measured using 3.75-MHz convex and 7.5-MHz linear probes, respectively.

Results. The mean PRFT and IMT in HIV-1-infected patients with visceral obesity was significantly greater than those in patients without it (p < 0.0001 and p < 0.01, respectively). Using the average IMT as the dependent variable in regression analysis, PRFT was an independent factor associated with carotid IMT (p < 0.05). A PRFT of 6.4 mm was the most discriminatory value for predicting an IMT >= 0.9 mm (sensitivity 83.3%, specificity 83.9%). Subjects with visceral obesity had a progressively increasing carotid IMT on the 12-month measurement (p < 0.05).

Conclusion. Our data demonstrated that PRFT measurement could be used as an early predictor of IMT increase in HIV-1-infected patients receiving highly active antiretroviral therapy. (C) 2010 Wiley Periodicals, Inc. J Clin Ultrasound 38:190-195, 2010; Published online in Wiley InterScience (www.interscience.wiley. corn). DOI: 10.1002/jcu.20664