Abstract
Objective Skeletal muscle quality and mass are important for maintaining physical function during advancing age. We leveraged baseline data from REPRIEVE to evaluate whether paraspinal muscle density and muscle area are associated with cardiac or physical function outcomes in people with HIV (PWH).
Methods REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events (MACE) in PWH. This cross-sectional analysis focuses on participants who underwent coronary CT at baseline. Lower thoracic paraspinal muscle density (Hounsfeld units, HU) and area (cm2) were assessed on non-contrast CT image.
Results Of 805 PWH, 708 had paraspinal muscle measurements. Median age was 51 years; 17% were natal female. Median muscle density was 41 HU (male), 30 HU (female); area 13.2 cm2/m (male) and 9.9 cm2/m (female). In adjusted analyses, greater density (less fat) was associated with lower prevalences of any coronary artery plaque, coronary artery calcium score >0, and high plaque burden (p=0.06); area was not associated with plaque measures. Among 139 with physical function measures, greater area (but not density) was associated with better performance on a short physical performance battery and grip strength.
Conclusion Among PWH, greater paraspinal muscle density was associated with lower prevalence of coronary artery disease, while greater area was associated with better physical performance. Whether changes in density or area are associated with changes in CAD or physical performance will be evaluated through longitudinal analyses in REPRIEVE.