Poorer Muscle Quality and Quantity With ART Initiation Is Associated With Greater Inflammation and Immune Activation.

Autor:	Kousari A; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO., Moser C; Harvard T.H. Chan School of Public Health, Boston, MA., Olefsky M; Harvard T.H. Chan School of Public Health, Boston, MA., Brown TT; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO., Currier JS; Department of Medicine, University of California Los Angeles, Los Angeles, CA., McComsey GA; Departments of Medicine and Pediatrics, Case Western Reserve, Cleveland, OH., Scherzinger A; Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO., Stein JH; Department of Medicine, University of Wisconsin, Madison, WI; and., Lake JE; Department of Medicine, University of Texas Houston, Houston, TX., Erlandson KM; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2021 Dec 01; Vol. 88 (4), pp. 399-405.
DOI:	10.1097/QAI.0000000000002776
Abstrakt:	Background: We have previously shown that the initiation of antiretroviral therapy (ART) is associated with a decrease in skeletal muscle density (greater fat accumulation), suggesting that gains in lean body mass seen in many ART studies may reflect gains in low quality, fatty muscle. Here, we explore whether skeletal muscle density and area are associated with markers of inflammation and immune activation. Methods: ART-naïve people with HIV were randomized to raltegravir or ritonavir-boosted atazanavir or darunavir, each with tenofovir disoproxil fumarate/emtricitabine. Abdominal computed tomography scans from baseline and week 96 were reanalyzed for psoas density and area and correlations explored with inflammation [interleukin-6 (IL-6) and high-sensitivity C-reactive protein] and immune activation [soluble CD14 (sCD14), soluble CD163 (sCD163), and %CD38+HLADR+ on CD4+ or CD8+ T cells]. Results: Two hundred twenty-two participants had available inflammation/immune activation markers and paired computed tomography scans. At baseline, lower psoas density (greater fat) correlated with higher IL-6 (r = -0.26, P < 0.001) and sCD163 (r -0.15, P = 0.03) and lower lean psoas area correlated with higher IL-6, high-sensitivity C-reactive protein, sCD14, sCD163, and %CD38+HLADR+ on CD4+ T cells (r = -0.30-0.13; all P ≤ 0.05). From baseline to week 96, greater percent decrease in total psoas density (more fat) correlated with greater increase in IL-6 (r = -0.14; P = 0.04); greater % decrease in lean psoas area correlated greater increases in IL-6, sCD14, sCD163, and %CD38+HLADR+ on CD8+ T cells (r = -0.15 to -0.18; all P < 0.04). Conclusions: Greater fat infiltration within the psoas muscle (lower density) and greater loss in lean psoas muscle area were associated with higher inflammation and immune activation, which may portend important effects on muscle function and cardiometabolic risk. Competing Interests: K.M.E. has received research funding from Gilead Sciences (paid to the University of Colorado) and consulting fees from ViiV Pharmaceuticals and Theratechnologies (paid to the University of Colorado). The remaining authors have no conflicts of interest to disclose. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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