Endocrine Abstracts

Introduction: Association between liver fibrosis and body mass index (BMI) is well known in HIV/HCV patients, is linked to worse lipid profile and is widely used to predict liver fibrosis in this population. Nevertheless, recent studies show a stronger link between dyslipidemia and liver stiffness with visceral adiposity index (VAI) in general population. The main aim of this study was to investigate the accuracy of VAI and BMI as predictors for liver fibrosis and dyslipidemia in a cohort of HIV/HCV co-infected patients.

Methods/design: We conducted a cross-sectional study in a cohort of HIV/HCV co-infected outpatients attended in our hospital. Demographic, clinical and anthropometric variables were collected. Liver stiffness was measured by transient elastography (Fibroscan™). Liver fibrosis was defined as the presence of a liver stiffness ≥7.2 kPa. Patients were classified as obese, if BMI≥30 kg/m², and as normal weight if BMI between 18.5 – 24.9 kg/m². Further, patients were divided into three groups according to VAI score tertiles.

Results: Thirty-nine HIV/HCV co-infected individuals (97.4% male, mean age: 47.4±5.2 years) were included. Patients with normal weight compared to obese individuals had significantly lower HDLc levels (41.4±8.8 mg/dl vs 51.4±16.7 mg/dl; P=0.03) but no differences were found in other lipid profile, in a univariate analysis. When the cohort was classified according to VAI tertiles, patients with the highest VAI score (third tertile) had higher triglycerides serum levels (233.1±81.2 vs 85.9±31.1 mg/dl; P<0.001), higher LDLc levels (115.1±40.1 vs 78±22.2 mg/dl; P=0.006) and lower HDLc (34.4±8.2 vs 60.9±16.7 mg/dl; P<0.001). Though both BMI and VAI showed a positive correlation with liver stiffness, this association was stronger for VAI than the observed for BMI (r=0.392; P=0.004 vs r=0.291; P=0.035).

Conclusions: According to our results, VAI score is more accurate than BMI to predict liver fibrosis and dyslipidemia in this population. We propose routine use of VAI to identify HIV/HCV co-infected patients at risk for liver fibrosis and/or dyslipidemia.