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High Irisin levels in nondiabetic HIV ‐infected males are associated with insulin resistance, nonalcoholic fatty liver disease, and subclinical atherosclerosis
Author(s) -
MorenoPerez Oscar,
ReyesGarcia Rebeca,
MuñozTorres Manuel,
Merino Esperanza,
Boix Vicente,
Reus Sergio,
Giner Livia,
Alfayate Rocío,
GarciaFontana Beatriz,
SanchezPaya Jose,
Picó Antonio,
Portilla Joaquín
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13800
Subject(s) - insulin resistance , nonalcoholic fatty liver disease , medicine , endocrinology , lipodystrophy , steatosis , subclinical infection , insulin , diabetes mellitus , type 2 diabetes , fatty liver , immunology , viral load , disease , human immunodeficiency virus (hiv) , antiretroviral therapy
Summary Objective HIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, nonalcoholic fatty liver disease ( NAFLD ) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV ‐infected males. Design Cross‐sectional study in a cohort of HIV ‐infected patients. Patients Inclusion criteria: men older than 18 years; antiretroviral therapy ( ART ) ‐naïve or on effective ART (<50 HIV ‐1 RNA copies/ mL ) without changes in the previous 6 months; no diabetes or hepatitis C. Measurements Irisin was measured by enzymatic immunoassay (Phoenix Pharmaceuticals), insulin sensitivity by homeostasis model assessment of insulin resistance ( HOMA ‐ IR ), as well as the 2‐hour continuous infusion of glucose with model assessment ( CIGMA ‐ HOMA ). Hepatic steatosis was measured by 1‐H magnetic resonance spectroscopy, subclinical atherosclerosis by evaluation of carotid intima‐media thickness (C‐ IMT ), measured by Ultrasonography. Results Eight nine men (age 42.0 ± 8.3 years, duration of HIV infection 7.9 ± 5.6 years, CD 4 count 547 ± 279 cells/ mL ) were included. Circulating irisin was positively related to HOMA ‐ IR and CIGMA ‐ HOMA , hepatic triglyceride content, and to VAT / SAT ratio. Higher irisin concentrations were associated with higher C‐ IMT , although this association did not persist in multivariate analysis. Lipodystrophy and a higher baseline PAI ‐1 concentration were independently associated with C‐ IMT . Conclusions In male HIV patients without diabetes, higher irisin concentrations are positively associated with insulin resistance, NAFLD and subclinical atherosclerosis. However, waist‐hip‐ratio is the main determinant of insulin resistance, and PAI ‐1 and lipodystrophy were the strongest determinants of IMT in this population.