Sonographically measured perirenal fat thickness: an early predictor of atherosclerosis in HIV-1-infected patients receiving highly active antiretroviral therapy?

ABSTRACT Purpose. The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a pa- rameter of central obesity, is related to carotid intima- media 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, respec- tively. 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 ca- rotid 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%). Sub- jects with visceral obesity had a progressively increasing carotid IMT on the 12-month measure- ment (p < 0.05). Conclusion. Our data demonstrated that PRFT mea- surement could be used as an early predictor of IMT increase in HIV-1-infected patients receiving highly active antiretroviral therapy.