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Objectives: We evaluated whether ophthalmic artery resistance index (OARI) is related to intima media thickness (IMT) of common carotid artery. Our hypothesis was that OARI could be an index of occlusive carotid artery disease and an early predictor of atherosclerosis in HIV-1 infected patients receiving highly active antiretroviral therapy (HAART). Methods: We enrolled 88 consecutive HIV-1-infected patients in a cross sectional study. All patients were receiving HAART for more than twelve months. OARI and IMT was measured by ultrasonography, using a 7.5 mHz linear probe. Multiple regression analysis was used to assess the independent association between the carotid IMT and OARI adjusting for various risk factors. The most discriminant cutoffs were calculated by receiver operating characteristic (ROC) curves. Results: For all patients OARI correlated well with carotid IMT (r = +0.56, p< 0.0001). Using the average IMT as the dependent variables in regression analysis, OARI was the independent factor associated with carotid IMT. ROC curves indicated that the most discriminant OARI value for predicting a clinically significant increase of IMT was >0.74 (sensitivity 86.7%, specificity 82.2%, AUC 0.87, p=0.0001). Conclusions: Our data indicate that ultrasonographic OARI measure- ment may have a potential to be a marker of increased endothelial damage and it could be used as an early predictor of IMT increase in HIV- 1-infected patients. As a consequence, a periodic screening for vascular resistance indexes should be considered mandatory in HIV-1-infected patients receiving HAART and it could identify patients at major risk to develop cardiovascular disease.

Scopo dello Studio Abbiamo valutato se lo spessore del grasso perirenale (PRFD), un parametro dell’obesità centrale, è collegato con l’indice di resistenza dell’arteria oftalmica (OARI), indice di malattia occlusiva del- l’arteria carotica. Il PRFD potrebbe essere un indice predittivo precoce di aterosclerosi in pazienti HIV-1+ che ricevono la terapia antiretrovirale altamente attiva (HAART). Metodi 144 oggetti successivi sono stati arruolati in quattro gruppi: pazienti HIV+ con obesità centrale (gruppo A, n = 38), pazienti HIV+ senza obesità centrale (gruppo B, n = 50), pazienti HIV-1 ne- gativi con obesità centrale (gruppo C, n = 30) ed individui sani (gruppo D, n = 30). La diagnosi di obesità centrale è stata basata sul rapporto di PRFD/BMI > 0.22 secondo i nostri dati recente- mente pubblicati. OARI è stato misurato usando un esame ecografico con sonda lineare da 7.5 megahertz. L’analisi di regressione logistica è stata usata per valutare l’associazione indipendente fra l’OARI e il PRFD. Risultati La media di OARI negli oggetti con obesità centrale era considerevolmente superiore a quella negli soggetti senza (0.73±0.04, gruppo A; 0.69±0.03, gruppo B; 0.74±0.04, gruppo C; 0.68±0.04, gruppo D) senza riguardo alla positività per HIV. Abbiamo dimostrato una correlazione positive tra OARI e PRFD (r = +0.52, p

Objectives: We evaluated whether perirenal fat diameter (PRFD), a parameter of central obesity, is related to ophthalmic artery resistance index (OARI), index of occlusive carotid artery disease. Our hypothesis was that PRFD could be an early predictor of atherosclerosis in HIV-1 infected patients receiving highly active antiretroviral therapy (HAART). Methods: 144 consecutive subjects were enrolled into four groups: HIV+ patients with central obesity (group A, n = 38), HIV+ patients without central obesity (group B, n = 50), HIV-1-negative patients with central obesity (group C, n = 30) and healthy subjects (group D, n = 30). Diagnosis of central obesity was based on PRFD/BMI ratio > 0.22 using 3.75 mHz convex transducer, according to our published data. OARI was measured using a 7.5 mHz linear probe scanning through closed eyelid. Demographic characteristics and metabolic variables were compared between groups by ANOVA. Logistic regression analysis was used to assess the independent association between the OARI and PRFD adjusting for various risk factors. Results: The mean of OARI in subjects with central obesity was considerably higher than that in subjects without (0.73±0.04, group A; 0.69±0.03, group B; 0.74±0.04, group C; 0.68±0.04, group D) regardless of HIV status. We further found a positive correlation between OARI and PRFD (r = +0.52, p< 0.0001). Using the average OARI as the dependent variable, age (Odds Ratio 1.13, 95%CI 1.04 to 1.23) and PRFD (Odds Ratio 1.44, 95%CI 1.12 to 1.85) were independent factors associated to OARI. Conclusions: Our data indicate that ultrasonographic assessment of PRFD may have a potential to be a marker of increased endothelial damage with specific involvement of ocular vascular district. As a consequence, a periodic screening for visceral obesity should be considered mandatory in HIV-1-infected patients receiving HAART and it could identify patients at major risk to develop cardiovascular disease.