Immune deficiency could be an early risk factor for altered insulin sensitivity in antiretroviral-naive HIV-1-infected patients: the ANRS COPANA cohort
Faroudy Boufassa, Cécile Goujard, Jean-Paul Viard, Robert Carlier, Bénédicte Lefebvre, Patrick Yeni, Olivier Bouchaud, Jacqueline Capeau, Laurence Meyer, Corinne Vigouroux, ANRS COPANA Cohort Study Group, Christine Rouzioux, Véronique Avettand-Feonël, Olivier Lortholary, Jean-Paul Viard, Ségolène Boucly, Aline Maignan, Claudine Duvivier, Rodolphe Thiébaut, Laurence Meyer, Faroudy Boufassa, Marie-Aline Charles, Rosemary Dray-Spira, Camille Legeai, Valentin Amon, Nacera Benammar, Remonie Seng, Gilles Pialoux, Laurence Slama, Philippe Bonnard, Catherine Chakvetedze, Thomas L'Yavanc, Jacqueline Capeau, Corinne Vigouroux, Soraya Fellahi, Jean-Philippe Bastard, Eric Oksenhendler, Laurence Gérard, Jean-François Bourge, Véronique Bajzik, Daniel Séréni, Caroline Lascoux-Combe, Claire Pintado, Olivier Taulera, Le Van Dien, Jeannine Delgado, Jean-Michel Molina, Thierry Saint-Marc, Samuel Ferret, Juliette Pavie, Jean-François Bergmann, Agathe Rami, Maguy Parrinello, Pierre-Marie Girard, Bénédicte Lefebvre, Chérif Boudraa, Bilguissa Diallo, Catherine Lupin, Serge Herson, Anne Simon, Nadia Edeb, Dominique Salmon-Céron, Loïc Guillevin, Tassadit Tahi, Marie Pierre Pietri, Laurence Weiss, Delphine Tisne-Dessus, Christelle Jalbert, Patrick Yeni, Sophie Matheron, Golriz Pahlavan, Bao Phung, Nadia El-Alami Talbi, Zahia Ramani, Giovanna Catalano, Cindy Godard, François Boué, Véronique Chambrin, Dominique Bornarel, Hélène Schoen, Robert Carlier, Bruno Fantin, Agnès Uludag, Caroline Poder, Robin Dhote, Michelle Bentata, Patricia Honoré, Unité Sida, Olivier Bouchaud, Xuan Tuyet, Jean-François Delfraissy, Cécile Goujard Fabrice Chaix, Marie-Thérèse Rannou, Yves Levy, Alain Sobel, Cécile Dumont, André Cabié, Sylvie Abel, Sandrine Pierre-François, Véronique Beaujolais, Isabelle Poizot-Martin, Olivia Zaegel-Faucher, Caroline Debreux, Jacques Moreau, Saadia Mokhtari, Evelyne Van Der Gheynst, Marie-Christine Thiebaut-Drobacheff, Adeline Foltzer, Bruno Hoen, Jean-François Faucher, Helder Gil, Michel Dupon, Jean-Marie Ragnaud, Isabelle Raymond, Philippe Morlat, Isabelle Louis, Mojgan Hessamfar, Jacques Reynes, Vincent Baillat, Corinne Merle De Boever, Christine Tramoni, Antoine Soufflet, Patrick Guadagnin, Frédéric Bastides, Patrick Choutet, Louis Bernard, François Raffi, Olivier Mounoury, Véronique Reliquet, Delphine Brosseau, Hervé Hue, Thierry May, Simone Wassoumbou, Mireille Stenzel, Marie-Pierre Bouillon, Yazdan Yazdanpanah, Thomas Huleux, Emmanuelle Aïssi, Simona Pavel, David Rey, Christine Cheneau, Patricia Fischer, Marialuisa Partisani, Gilles Blaison, Mahsa Mohseni Zadeh, Martin Martinot, Anne Pachart, François Jeanblanc, Jean-Louis Touraine, Christian Trépo, Patrick Miailhes, Koffi Kouadjo, Valérie Thoirain, Corinne Brochier, Philippe Perré, Sophie Leautez, Jean Luc Esnault, Isabelle Suaud, Faroudy Boufassa, Cécile Goujard, Jean-Paul Viard, Robert Carlier, Bénédicte Lefebvre, Patrick Yeni, Olivier Bouchaud, Jacqueline Capeau, Laurence Meyer, Corinne Vigouroux, ANRS COPANA Cohort Study Group, Christine Rouzioux, Véronique Avettand-Feonël, Olivier Lortholary, Jean-Paul Viard, Ségolène Boucly, Aline Maignan, Claudine Duvivier, Rodolphe Thiébaut, Laurence Meyer, Faroudy Boufassa, Marie-Aline Charles, Rosemary Dray-Spira, Camille Legeai, Valentin Amon, Nacera Benammar, Remonie Seng, Gilles Pialoux, Laurence Slama, Philippe Bonnard, Catherine Chakvetedze, Thomas L'Yavanc, Jacqueline Capeau, Corinne Vigouroux, Soraya Fellahi, Jean-Philippe Bastard, Eric Oksenhendler, Laurence Gérard, Jean-François Bourge, Véronique Bajzik, Daniel Séréni, Caroline Lascoux-Combe, Claire Pintado, Olivier Taulera, Le Van Dien, Jeannine Delgado, Jean-Michel Molina, Thierry Saint-Marc, Samuel Ferret, Juliette Pavie, Jean-François Bergmann, Agathe Rami, Maguy Parrinello, Pierre-Marie Girard, Bénédicte Lefebvre, Chérif Boudraa, Bilguissa Diallo, Catherine Lupin, Serge Herson, Anne Simon, Nadia Edeb, Dominique Salmon-Céron, Loïc Guillevin, Tassadit Tahi, Marie Pierre Pietri, Laurence Weiss, Delphine Tisne-Dessus, Christelle Jalbert, Patrick Yeni, Sophie Matheron, Golriz Pahlavan, Bao Phung, Nadia El-Alami Talbi, Zahia Ramani, Giovanna Catalano, Cindy Godard, François Boué, Véronique Chambrin, Dominique Bornarel, Hélène Schoen, Robert Carlier, Bruno Fantin, Agnès Uludag, Caroline Poder, Robin Dhote, Michelle Bentata, Patricia Honoré, Unité Sida, Olivier Bouchaud, Xuan Tuyet, Jean-François Delfraissy, Cécile Goujard Fabrice Chaix, Marie-Thérèse Rannou, Yves Levy, Alain Sobel, Cécile Dumont, André Cabié, Sylvie Abel, Sandrine Pierre-François, Véronique Beaujolais, Isabelle Poizot-Martin, Olivia Zaegel-Faucher, Caroline Debreux, Jacques Moreau, Saadia Mokhtari, Evelyne Van Der Gheynst, Marie-Christine Thiebaut-Drobacheff, Adeline Foltzer, Bruno Hoen, Jean-François Faucher, Helder Gil, Michel Dupon, Jean-Marie Ragnaud, Isabelle Raymond, Philippe Morlat, Isabelle Louis, Mojgan Hessamfar, Jacques Reynes, Vincent Baillat, Corinne Merle De Boever, Christine Tramoni, Antoine Soufflet, Patrick Guadagnin, Frédéric Bastides, Patrick Choutet, Louis Bernard, François Raffi, Olivier Mounoury, Véronique Reliquet, Delphine Brosseau, Hervé Hue, Thierry May, Simone Wassoumbou, Mireille Stenzel, Marie-Pierre Bouillon, Yazdan Yazdanpanah, Thomas Huleux, Emmanuelle Aïssi, Simona Pavel, David Rey, Christine Cheneau, Patricia Fischer, Marialuisa Partisani, Gilles Blaison, Mahsa Mohseni Zadeh, Martin Martinot, Anne Pachart, François Jeanblanc, Jean-Louis Touraine, Christian Trépo, Patrick Miailhes, Koffi Kouadjo, Valérie Thoirain, Corinne Brochier, Philippe Perré, Sophie Leautez, Jean Luc Esnault, Isabelle Suaud
Abstract
Background: The relationships between immunovirological status, inflammatory markers, insulin resistance and fat distribution have not been studied in recently diagnosed (<1 year) antiretroviral-naive HIV-1-infected patients.
Methods: We studied 214 antiretroviral-naive patients at enrolment in the metabolic substudy of the ANRS COPANA cohort. We measured clinical, immunovirological and inflammatory parameters, glucose/insulin during oral glucose tolerance test (OGTT), adipokines, subcutaneous and visceral fat surfaces (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT], assessed by computed tomography) and the body fat distribution based on dual-energy X-ray absorptiometry (DEXA).
Results: Median age was 36 years; 28% of the patients were female and 35% of sub-Saharan origin; 20% had low CD4(+) T-cell counts (≤200/mm(3)). Patients with low CD4(+) T-cell counts were older and more frequently of sub-Saharan Africa origin, had lower body mass index (BMI) but no different SAT/VAT ratio and fat distribution than other patients. They also had lower total, low-density lipoprotein and high-density lipoprotein cholesterolaemia, higher triglyceridaemia and post-OGTT glycaemia, higher markers of insulin resistance (insulin during OGTT and homeostasis model assessment of insulin resistance) and of inflammation (high-sensitivity C-reactive protein, IL-6, tumour necrosis factor (TNF)-α, sTNFR1 and sTNFR2). After adjustment for age, sex, geographic origin, BMI and waist circumference, increased insulin resistance was not related to any inflammatory marker. In multivariate analysis, low CD4(+) T-cell count was an independent risk factor for altered insulin sensitivity (β-coefficient for HOMA-IR: +0.90; P=0.001; CD4(+) T-cell count >500/mm(3) as the reference), in addition to older age (β: +0.26 for a 10-year increase; P=0.01) and higher BMI (β: +0.07 for a 1-kg/m(2) increase; P=0.003).
Conclusions: In ART-naive patients, severe immune deficiency but not inflammation could be an early risk factor for altered insulin sensitivity.
Source: PubMed