Observational studyJCI insight2026
A distinct form of fat fibrosis is linked to insulin resistance in people with HIV.
Observational study in JCI insight, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03022682 (Development of a Multi-Ethnic, Multimodal Obesity Cohort), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Development of a Multi-Ethnic, Multimodal Obesity Cohort
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0 citing papers in PubMed.
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Authors and funding
17 authors.
Funding
Abstract
BACKGROUNDDespite antiretroviral therapy (ART), people with HIV (PWH) are at heightened risk for insulin resistance (IR) and type 2 diabetes (T2D). Subcutaneous adipose tissue (SAT) fibrosis contributes to metabolic disease, but its role in IR among PWH is unknown. We investigated the relationship between SAT fibrosis and IR in PWH, along with transcriptional signatures to distinguish it from SAT fibrosis due to obesity.METHODSWe analyzed body composition and SAT fibrosis (hydroxyproline) in 46 PWH and 74 people without HIV (PWoH), excluding individuals with T2D. We examined fibrosis-related gene transcription in the SAT using a targeted panel and measured plasma endotrophin, a marker of extracellular matrix (ECM) remodeling.RESULTSPWH had substantially more SAT fibrosis than PWoH, notably in nonobese individuals. Moreover, SAT fibrosis in these PWH was strongly associated with IR, independent of prior legacy ART or ongoing integrase strand inhibitor treatment. This SAT fibrosis was highlighted by a distinct transcriptional pattern marked by upregulation of COL14A1, key immune-related genes (e.g., CCL4, NLRP3), and pathways governing ECM remodeling and immune activation, as well as downregulation of thermogenic, lipid metabolic, and insulin signaling pathways. Plasma endotrophin levels were also elevated in PWH and correlated independently with SAT fibrosis.CONCLUSIONSAT fibrosis was associated with IR independent of obesity in PWH and was mirrored by circulating endotrophin levels, offering a plausible noninvasive biomarker for early intervention. The distinct transcriptional signature of HIV-associated SAT fibrosis highlights candidate mechanisms that may underlie metabolic risk and offer therapeutic avenues in this population.TRIAL REGISTRATIONClinicalTrials.gov NCT03022682.FUNDINGR01DK141041; R01DK112304; R56DK133997; K08DK124679; T32DK007418; P30DK098722; P30AI027763; Robert Wood Johnson Foundation; Harold Amos Medical Faculty Development Program.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.