Adipose Tissue and Metabolic Factors Associated With Steatosis in HIV/HCV Coinfection: Histology Versus Magnetic Resonance Spectroscopy

作者：Ghotb Alireza; Noworolski Susan M; Madden Erin; Scherzer Rebecca; Qayyum Aliya; Pannell Jane; Ferrell Linda; Peters Marion; Tien Phyllis C^*

来源：JAIDS: Journal of Acquired Immune Deficiency Syndromes , 2010, 55(2): 228-231.

DOI：10.1097/QAI.0b013e3181e1d963

• adipose tissue
• HIV
• HCV
• insulin resistance
• magnetic resonance spectroscopy
• steatosis

Background: Hepatic steatosis is common in persons with HIV and hepatitis C virus (HCV); yet biopsy measurement of steatosis is prone to sampling error. We compared magnetic resonance spectroscopy (MRS) measurement of steatosis to histology in HIV/HCV-coinfected patients and explored the associated adipose tissue and metabolic factors.
Methods: Cross-sectional analysis of 42 HIV/HCV-coinfected men and women. Logistic regression analysis identified factors (MRI-measured visceral adipose tissue and abdominal subcutaneous adipose tissue and Homeostasis Model Assessment-estimated insulin resistance) associated with histologic steatosis (>= 5% of hepatocytes with fat) and MRS steatosis (>= 5% of hepatic fat).
Results: MRS steatosis was strongly associated with histologic steatosis, when measured continuously (odds ratio: 10.2 per doubling of MRS-measured hepatic fat; 95% confidence interval: 2.9 to 69.3) and dichotomously (Kappa coefficient = 0.52; P = 0.0007). Four of the 10 with MRS-measured steatosis did not have histologic steatosis; 3 of 9 with histologic steatosis did not have MRS-measured steatosis (67% sensitivity; 88% specificity). Associations of visceral adipose tissue and abdominal subcutaneous adipose tissue were associated with both histologic and MRS-measured steatosis. Insulin resistance was also associated with both.
Conclusions: When compared with histology, MRS was similarly associated with adipose tissue and metabolic factors. MRS is a useful noninvasive alternative to biopsy in HIV/HCV coinfection.

• 出版日期2010-10-1