NYMC Faculty Publications


Abdominal Fat Depots, Insulin Resistance, and Incident Diabetes Mellitus in Women With and Without HIV Infection

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Epidemiology and Community Health


OBJECTIVE: To determine the associations between visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) mass with homeostatic model assessment-insulin resistance (HOMA-IR) and incidence of diabetes mellitus in women with and without HIV infection. DESIGN: Cross-sectional design for associations between abdominal fat and HOMA-IR; longitudinal design for associations between abdominal fat and incident diabetes. METHODS: We assessed associations between dual X-ray absorptiometry scan-derived VAT and SAT with HOMA-IR in a subsample from the Women's Interagency HIV Study (n = 226 with and n = 100 without HIV) using linear regression. We evaluated associations of VAT, SAT, and HOMA-IR with incident diabetes mellitus using Cox proportional hazards models. RESULTS: VAT mass was positively associated with log HOMA-IR in fully adjusted linear regression models stratified by HIV serostatus, including adjustment for SAT. During median follow-up of 10.6 years, incidence of diabetes was 1.63 [95% CI 1.15, 2.31] and 1.32 [95% CI 0.77, 2.28] cases per 100 person-years in women with and without HIV (P = 0.52). In a fully adjusted model, baseline VAT (hazard ratio [HR] 2.64 per kg; 95% CI [1.14, 6.12]; P = 0.023) and SAT (HR 1.34 per kg; 95% CI [0.73, 2.45]; P = 0.35) were associated with incident diabetes but the latter was not statistically significant. CONCLUSIONS: VAT mass was independently associated with HOMA-IR in women with and without HIV and was independently associated with future development of diabetes.