Ultrasound-Based Assessment of Preperitoneal Fat as a Surrogate Marker of Cardiovascular Risk: Comparative Study Between People Living With HIV and Controls.

Background: Optimal management of cardiovascular disease should start with the identification of subjects at subclinical stages. However, available tools are not always accurate or affordable. We assess the usefulness of ultrasound-guided measurement of abdominal fat layers as a surrogate marker of cardiovascular risk.

Methods: We performed a cross-sectional, case-control, exploratory, pilot study in 10 PLWH and 10 HIV-uninfected subjects (control group) matched for age, sex, and body mass index. All participants were men aged 45-60 years, with no active diseases or previous abdominal surgery; the PLWH group had been virologically suppressed for ≥2 years under stable antiretroviral therapy. The thickness of abdominal superficial and deep subcutaneous fat, preperitoneal fat, omental (periaortic) fat, and retroperitoneal (perirenal) fat was compared between both groups. Correlations between fat layers and traditional markers of cardiovascular risk were assessed.

Results: The thickness of most of the layers was always higher among PLWH. The differences were statistically significant for the preperitoneal fat layer (p=0.04). The presence of atherosclerotic plaque was correlated with the preperitoneal fat layer in the PLWH group (odds ratio=1.49, p=0.02), and metabolic syndrome was correlated with superficial subcutaneous fat, although this was low (odds ratio=0.54, p=0.02). In the control group, several associations were found between carotid intima media thickness and abdominal fat layers.

Conclusion: The thickness of most of the layers was always higher among PLWH. The differences were statistically significant for the preperitoneal fat layer (p=0.04). The presence of atherosclerotic plaque was correlated with the preperitoneal fat layer in the PLWH group (odds ratio=1.49, p=0.02), and metabolic syndrome was correlated with superficial subcutaneous fat, although this was low (odds ratio=0.54, p=0.02). In the control group, several associations were found between carotid intima media thickness and abdominal fat layers.