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Sponsor: Vanderbilt University Medical Center
Conditions: Hiv, Diabetes Mellitus, Type 2
Interventions: Subcutaneous adipose tissue biopsy, CT scan, Oral glucose tolerance test, Blood collection
Countries: United States
With the introduction of effective anti-retroviral therapy (ART), HIV-infected persons can now survive for decades, but this success has been accompanied by an increased risk of developing metabolic disease and diabetes in HIV-infected persons compared to the general population. Recent studies from HIV-negative subjects have identified several associations between circulating immune cell populations and impaired glucose tolerance, including increased activated CD4+ and CD8+ T cells, and reduced regulatory T cells. Of note, these same changes in peripheral T cell subsets are frequently observed in patients with chronic HIV infection. The goal of this study is to assess whether the circulating T cell distribution is reflective of the adipose tissue T cell distribution, and to understand whether chronic adipose tissue T cell activation may impair adipocyte (i.e., fat cell) function and insulin sensitivity. If the investigators' hypotheses are correct, this will demonstrate that chronic peripheral immune activation (i.e., high memory T cells, low naïve cells, and increased expression of activation surface markers) is associated with greater adipose-resident CD4+ and CD8+ T cell expression of activation markers, adipose tissue inflammation, and insulin resistance.
Sex: ALL
Age: 18 Years to —
Healthy volunteers: Yes
Study type: OBSERVATIONAL
HIV+ Participants: Inclusion Criteria: * On antiretroviral therapy for at least 18 months * HIV-1 RNA \<400 copies/ml for the prior 12 months * CD4+ count \>350 cells/µl in the prior 12 months * HbA1c in prior 6 months within specified limits (See Figure) * Pre-menopausal by self-report or post-menopausal but not on hormone replacement therapy (HRT) Exclusion Criteria: * Known inflammatory or rheumatologic conditions * Heavy alcohol (\>11 drinks per week) or cocaine, amphetamine, or illicit (non-prescribed) opiate abuse by self-report * Current use of DPP-4 inhibitors. HIV-negative Participants: Inclusion Criteria: * A HbA1c \>6.5% or a fasting glucose \>126mg/dl, or on anti-diabetic medications for at least 6 months * Pre-menopausal by self-report or post-menopausal but not on hormone replacement therapy (HRT) Exclusion criteria: * Known inflammatory or rheumatologic conditions * Heavy alcohol (\>11 drinks per week) or cocaine, amphetamine, or illicit (non-prescribed) opiate abuse by self-report * Current use of DPP-4 inhibitors.
- Nashville, Tennessee, United States