VISCERAL ADIPOSITY IN A GROUP OF MEN ON ANTIRETROVIRAL THERAPY IS ASSOCIATED WITH LOW SERUM TESTOSTERONE

W Wobeser¹, P Ford ¹, S Tenzif², R Ross^1
1Queen’s University, Kingston, Ontario; ¹Riverdale Hospital, Toronto, Ontario

Background: Exogenous testosterone is indicated for HIV associated wasting syndrome, however, the effect of exogenous testosterone on body habitus changes in HIV is not known. Visceral adiposity is a marker of increased metabolic risk for cardiovascular events which is a common finding among persons on antiretroviral therapy.
Methods: This was a cross sectional study of males with HIV infection on antiretroviral therapy including those on and not on exogenous anabolic steroids to determine if there was a difference in body habitus (using MRI), metabolic factors and quality of life (MOS-HIV). Multiple variable linear regression was performed to analyze associations with visceral fat (L4/5 on MRI).
Results: Fourty-four patients were enrolled and received a metabolic evaluation and MRI for body composition. 13 were on intramuscular testosterone and 31 not. Serum testosterone (22.9±9.5 vs. 20.3±10.0) and L4/5 visceral fat (106.8±61.6 vs. 133.0±54.0) was not different among the two groups. Increased L4/5 fat, however, was found to be independently associated with increasing age (p=0.07), increasing duration of HIV (p=0.02), low serum testosterone (p=0.01) and increased serum insulin (p=0.02). Those on exogenous testosterone had a higher triglyceride (4.0 vs. 2.3; p=0.02) and cholestrol/HDL ratio (6.8 vs. 5.5; p=0.01) than those not. No effect of either serum or exogenous testosterone was seen with muscle or subcutaneous adipose tissue. The only QOL difference for the two groups was a higher level of health distress among those on exogenous testosterone (p=0.03).
Conclusions: Our findings support a relationship between visceral adiposity and testosterone which may be beneficial, however these may be counterbalanced by independent metabolic effects of exogenous testosterone.