Key result
HIV infection is linked to ~53% higher lipocalin-2 levels regardless of antiretroviral therapy.
Why the study?
Metabolic and cardiovascular diseases represent a major problem in HIV infection, and the relationship of HIV and ART with adipokines linked to adipose tissue dysfunction and CVD is unclear.
Does HIV infection and antiretroviral therapy affect circulating levels of Lipocalin-2 and FABP-4 in non-obese patients?
Cross-Sectional (n=50)
No
Does HIV infection and antiretroviral therapy affect circulating levels of Lipocalin-2 and FABP-4 in non-obese patients?
Lipocalin-2 may serve as a useful marker for HIV- and ART-related adipose tissue dysfunction, whereas FABP-4 correlates with metabolic and CVD risk independently of HIV status.
Lipocalin-2 elevation was associated with HIV and NNRTI use; hypothesis-generating for adipose dysfunction marker, needs prospective validation.
BACKGROUND: Metabolic and cardiovascular diseases (CVD) represent a major problem in HIV infection. The aim of this study was to evaluate the relationship of HIV infection and antiretroviral therapy (ART) with circulating levels of two adipokines (Lipocalin-2 and Fatty Acid Binding Protein-4, FABP-4), known to be associated with adipose tissue dysfunction and cardiovascular disease in the general population. METHODS: We enrolled 40 non-obese HIV-infected patients and 10 healthy controls of similar age and Body Mass Index (BMI). Body composition, metabolic syndrome, lipid profile, 10-years CVD risk score, and adipokines levels were compared between groups. ART-regimen status (naïve, non-nucleoside reverse transcriptase inhibitors - NNRTIs - and protease inhibitors - PIs) association with adipokines levels was tested with linear regression models. RESULTS: HIV patients showed a worse metabolic profile than controls. Lipocalin-2 levels were higher in HIV-infected subjects (+53%; p = 0.007), with a significant trend (p = 0.003) for higher levels among subjects taking NNRTIs. Association of lipocalin-2 with fat-mass and BMI was modulated by ART regimens, being positive among subjects treated with NNRTIs and negative among those treated with PIs ("ART-regimens-by-BMI" interaction p = 0.0009). FABP-4 levels were correlated with age, fat mass, BMI, lipid profile and CVD risk (all R ≥ 0.32, p < 0.05), but not influenced by HIV-status (+20%; p = 0.12) or ART-regimen (p = 0.4). CONCLUSIONS: Our data confirm that HIV-infection is associated with adipose tissue inflammation, as measured by Lipocalin-2 levels, and ART does not attenuate this association. While FABP-4 is a marker of worse metabolic and CVD profile independently of HIV status or ART regimen, lipocalin-2 could represent a useful marker for HIV- and ART-related adipose tissue dysfunction.
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Morieri et al. (2018) conducted a cross-sectional in HIV infection (n=50). HIV infection vs. Healthy HIV-uninfected controls was evaluated on Lipocalin-2 levels (ng/ml) (+53%, p=0.007). HIV-infected patients had 53% higher levels of lipocalin-2 compared to healthy controls (p=0.007), indicating adipose tissue inflammation that is not attenuated by antiretroviral therapy.
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