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Serum adipocytokines are related to lipodystrophy and metabolic disorders in HIV-infected men under antiretroviral therapy.
- Source :
-
AIDS (London, England) [AIDS] 2003 Jul 04; Vol. 17 (10), pp. 1503-11. - Publication Year :
- 2003
-
Abstract
- Objectives: Adipocytokines, secreted by adipose tissue, may regulate fat metabolism, lipid and glucose homeostasis and insulin sensitivity. We analysed the relations between circulating concentrations of adiponectin, leptin, interleukin-6, tumor necrosis factor alpha and its soluble receptors sTNFR1 and R2, lipodystrophic phenotypes and metabolic alterations in patients under highly active antiretroviral therapy (HAART).<br />Methods: We studied 131 consecutive HIV-infected males under protease inhibitor (PI)-based HAART, with body mass index < 27 kg/m2 and C-reactive protein (CRP) < 10 mg/l. Patients were classified in four groups according to clinical examination: no lipodystrophy (NL), lipohypertrophy (LH), lipoatrophy (LA) and mixed lipodystrophy (ML). In addition to adipocytokines, we measured plasma fasting levels of triglycerides, cholesterol, cardiovascular risk markers (high-sensitivity CRP and apolipoproteins B/A1 ratio), fasted and 2 h post-glucose loading glycemia and insulinemia and calculated the quantitative insulin sensitivity check index.<br />Results: The patients were HIV-infected and PI-treated for a mean of 8.2 and 1.6 years respectively; 74% presented lipodystrophy, 38% altered glucose tolerance and 42% hypertriglyceridemia. Insulin sensitivity correlated positively with adiponectin and negatively with leptin and interleukin-6. Adiponectin, but not leptin, negatively correlated with all metabolic parameters. Insulin resistance, metabolic defects and cardiovascular risk markers were strongly negatively correlated with the adiponectin/leptin ratio (A/L), and positively with sTNFR1. LA patients had a longer duration of infection but ML patients presented the most severe metabolic alterations, insulin resistance and A/L decrease.<br />Conclusions: These results suggest that adiponectin and the TNFalpha system are related to lipodystrophy, insulin resistance and metabolic alterations in patients under PI-based HAART. A/L and sTNFR1 could predict insulin sensitivity and potential cardiovascular risk in these patients.
- Subjects :
- Adiponectin
Adult
Aged
Antigens, CD blood
Antiretroviral Therapy, Highly Active
Apolipoproteins A analysis
Apolipoproteins B analysis
C-Reactive Protein analysis
Cholesterol blood
HIV Infections drug therapy
HIV-Associated Lipodystrophy Syndrome blood
HIV-Associated Lipodystrophy Syndrome drug therapy
Humans
Interleukin-6 blood
Leptin blood
Male
Middle Aged
Proteins analysis
Receptors, Tumor Necrosis Factor blood
Receptors, Tumor Necrosis Factor, Type I
Receptors, Tumor Necrosis Factor, Type II
Regression Analysis
Triglycerides blood
Tumor Necrosis Factor-alpha analysis
Adipose Tissue immunology
Anti-HIV Agents therapeutic use
Cytokines blood
HIV-1
HIV-Associated Lipodystrophy Syndrome immunology
Intercellular Signaling Peptides and Proteins
Subjects
Details
- Language :
- English
- ISSN :
- 0269-9370
- Volume :
- 17
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- AIDS (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 12824788
- Full Text :
- https://doi.org/10.1097/00002030-200307040-00011