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American Journal of Epidemiology Advance Access published online on March 8, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj111
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received August 2, 2005
Accepted December 14, 2005

PRACTICE OF EPIDEMIOLOGY

The Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM): Methods, Design, and Sample Characteristics

Phyllis C. Tien 1 *, Constance Benson 2, Andrew R. Zolopa 3, Stephen Sidney 4, Dennis Osmond 5, Carl Grunfeld 1, and for the FRAM Study Investigators

1 Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA; Department of Veterans Affairs Medical Center, San Francisco, CA
2 Department of Medicine, School of Medicine, University of California, San Diego, CA
3 Department of Medicine, School of Medicine, Stanford University, Stanford, CA
4 Division of Research, Kaiser Permanente, Oakland, CA
5 Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA

* To whom correspondence should be addressed.
Phyllis C. Tien, E-mail: ptien{at}medicine.ucsf.edu


  Abstract

The Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM), initiated in 2000, investigates the prevalence and correlates of changes in fat distribution, insulin resistance, and dyslipidemia among human immunodeficiency virus (HIV)-infected men and women compared with a population-based group of control men and women. Between June 2000 and September 2002, 1,480 participants (1,183 HIV-infected persons and 297 controls) were enrolled in FRAM. Measurements taken included whole-body magnetic resonance imaging for quantification of regional fat, anthropometric measurements, central laboratory analysis of metabolites, and assessment of symptoms, sociodemographic factors, and lifestyle. Similar measurements were repeated among FRAM participants 4 years later (FRAM 2) for investigation of the progression of fat distribution changes, insulin resistance, and hyperlipidemia. In FRAM 2, which is ongoing, investigators are also determining the associations of subclinical cardiovascular disease, as measured by carotid intimal-medial wall thickness, with HIV infection, fat distribution changes, insulin resistance, and other proatherogenic changes in serum lipid levels. The demographic characteristics of HIV-infected FRAM men and women were comparable to those reported from a national random sampling of HIV-infected men and women receiving medical care in the United States. The representativeness of the FRAM sample increases its value as a resource for studies on fat distribution, metabolic changes, and atherosclerosis in HIV infection.

Keywords: body fat distribution; dyslipidemias; HIV infections; insulin resistance; lipodystrophy; metabolism.
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