NYMC Faculty Publications

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

Journal Title

AIDS

First Page

1643

Last Page

1650

Document Type

Article

Publication Date

7-1-2018

Department

Epidemiology and Community Health

Abstract

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.

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