Serum adipocytokines are related to lipodystrophy and metabolic disorders in HIV-infected men under antiretroviral therapy.

• 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). 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. 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. 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.
• Authors: Corinne Vigouroux, Mustapha Maachi, Thu-Huyen Nguyên, Christiane Coussieu, Shahin Gharakhanian, Tohru Funahashi, Yuji Matsuzawa, Iichiro Shimomura, Willy Rozenbaum, Jacqueline Capeau, Jean-Philippe Bastard (Affiliation: INSERM U.402, Faculté de Médecine Saint-Antoine, Paris, France.)
• Journal: AIDS (London, England) (AIDS) Vol. 17 Issue 10 Pg. 1503-11 (Jul 4 2003) ISSN: 0269-9370 [Print] England
• PMID: 12824788 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adiponectin
• Anti-HIV Agents
• Antigens, CD
• Apolipoproteins A
• Apolipoproteins B
• Cytokines
• Intercellular Signaling Peptides and Proteins
• Interleukin-6
• Leptin
• Proteins
• Receptors, Tumor Necrosis Factor
• Receptors, Tumor Necrosis Factor, Type I
• Receptors, Tumor Necrosis Factor, Type II
• Triglycerides
• Tumor Necrosis Factor-alpha
• Cholesterol
• C-Reactive Protein

Topics

• Adiponectin
• Adipose Tissue (immunology)
• Adult
• Aged
• Anti-HIV Agents (therapeutic use)
• Antigens, CD (blood)
• Antiretroviral Therapy, Highly Active
• Apolipoproteins A (analysis)
• Apolipoproteins B (analysis)
• C-Reactive Protein (analysis)
• Cholesterol (blood)
• Cytokines (blood)
• HIV Infections (drug therapy)
• HIV-1
• HIV-Associated Lipodystrophy Syndrome (blood, drug therapy, immunology)
• Humans
• Intercellular Signaling Peptides and Proteins
• 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)