Background: In HIV-uninfected populations, physical activity decreases mortality and reduces inflammation. Persistent inflammation is a potential cause for increased co-morbidities in HIV+ adults, yet the evidence examining the effect of physical activity on cardiometabolic health and inflammation in this population is limited. This analysis examines the relationship between physical activity and markers of cardiometabolic health and inflammation.
Methods: We conducted a nested study within the SATURN-HIV trial in which 147 HIV+ adults on stable antiretroviral therapy (ART), with HIV-1 RNA< 1,000 copies/mL and LDL-cholesterol <130mg/dL were randomized to 10 mg daily rosuvastatin or placebo. Measures of physical activity, cardiometabolic health, and inflammation were assessed at baseline and 24 weeks later. Spearman correlations were used to explore relationships between physical activity, inflammation and CVD risk markers. Multivariable analyses were conducted to assess associations with physical activity.
Results: Median age (Q1, Q3) was 46 (40.4, 52.7) years, 80% were male, 69% were African American and 46% on protease inhibitors. Baseline median physical activity was 49.5 (30.1, 67.9) minutes per week. Physical activity was significantly correlated with several markers of cardiometabolic health and inflammation (all p<0.05) (see table). After adjustment for factors known to affect cardiometabolic health and inflammation, physical exercise remained independently associated with markers of vascular disease (carotid bulb intima-media thickness; β=<-0.01, p=0.03) and endothelial function (brachial hyperemic velocity-time integral; β= <0.01, p=0.04). In addition, physical activity (β =0.003, p<0.01) was independently associated with insulin resistance (HOMA-IR), even after adjustment for diabetes risk factors, HIV factors, body composition, and inflammation. After 24 weeks, median physical activity was 46.7 (31.4, 64.8) minutes per week and there was no difference between the statin and placebo groups. Changes in physical activity were correlated with changes in insulin resistance (α=0.19, p=0.03).
Conclusions: Physical activity is independently associated with insulin resistance, vascular disease and endothelial function, and may be a low-risk adjuvant to decreasing co-morbidities in HIV+ adults. Further studies should examine long-term effects of physical activity on markers of cardiometabolic health and inflammation in this population.