No evidence of a synergistic effect of HIV infection and diabetes mellitus type 2 on fat distribution, plasma adiponectin or inflammatory markers

BackgroundAltered fat distribution and chronic inflammation are found in both persons living with HIV (PLWH) and persons with diabetes mellitus type 2 (DM2) and are known risk factors for cardiovascular diseases (CVD). We aimed to investigate if a synergistic effect of HIV infection and DM2 was found on fat distribution and inflammation.MethodsA cross-sectional study was performed including PLWH with HIV RNA <200 copies/mL (18 with DM2 (HIV+DM2+), 18 without DM2 (HIV+DM2-)) and controls (19 with DM2 (controls with DM2) and 25 without DM2 (healthy controls). We measured fat distribution using dual-energy X-ray absorptiometry scan. Plasma concentrations of adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alfa (TNF- <alpha>) and soluble CD14 (sCD14) was measured using snap-frozen plasma.ResultsHIV+DM2+ and HIV+DM2- had comparable trunk/limb fat ratio. In contrast, HIV+DM2+ had a higher trunk/ limb fat ratio than controls with DM2 and healthy controls (p=0.013 and p<0.001, respectively). However, HIV+DM2+ and controls with DM2 had comparable amount of trunk fat mass (kg) (p=0.254). A lower concentration of plasma adiponectin and higher concentration of IL-6 was found in HIV+DM2+ than in HIV+DM2-(p=0.037 and p=0.039) and in healthy controls (p=0.001 and p=0.012). In contrast, plasma adiponectin and IL-6 concentrations were comparable in HIV+DM2+ and controls with DM2 (p=0.345 and p=0.825). Concentration of sCD14 was comparable in HIV+DM2+ and HIV+DM2-(p=0.850), but elevated in HIV+DM2+ compared to controls with DM2 (p<0.001) and healthy controls (p=0.007). No statistical interactions were found between HIV infection and DM2 for any of the depending variables.ConclusionA synergistic effect of HIV and DM2 was not found for any of the outcomes. However, HIV+DM2+ had features related to both HIV infection and DM2 with a high trunk/limb ratio, high trunk fat mass, low concentration of plasma adiponectin and elevated concentrations of IL-6 and sCD14. This could contribute to elevated risk of CVD.