Impact of antiretroviral therapy on selected metabolic disorders - pilot study.

Abstract

BACKGROUND:

Taking into consideration the aging of HIV infected individuals, changes in the metabolism aggravated by the antiretroviral therapy significantly impact their health. Mechanisms responsible for lipodystrophy, dyslipidemia and insulin resistance (IR) occurrence have not been completely understood. Only recently, the free fatty acids (FFAs) metabolic turnover has become considered to be the independent risk factor for cardiovascular complications.

MATERIAL AND METHODS:

We designed the follow-up study in which patients were recruited before the introduction of ARV therapy and then observed up to 1 year. The impact of ARV therapy on the development of metabolic complications, inflammation markers and changes in adipokines secretion was investigated. The fasting and postprandial responses of FFAs, triglycerides (TG), glucose, insulin and glucose-dependent insulinotropic peptide (GIP) were measured. Changes in body composition were followed by impedance and a CT scan of adipose tissue volume of the abdomen and thighs.

RESULTS:

Significant impact of ARV therapy on metabolic disturbances was reported. Not only fasting, but also postprandial levels of FFAs and TG were found to increase during the follow up.

CONCLUSIONS:

The increased concentration of FFAs is suggested to be the triggering event in the development of hypertriglyceridemia and insulin resistance during ARV therapy. Changes in postprandial FFAs and TG during the follow up indicate the increasing risk of cardiovascular diseases. We conclude that modern ARV therapy during the period of 12 months does not induce changes in the fat distribution, although increased limb fat correlated with higher plasma leptin level, which may be the marker of increased risk of metabolic driven cardiovascular complications.

• Authors: Monika Bociąga-Jasik, Anna Polus, Joanna Góralska, Urszula Raźny, Dominika Siedlecka, Barbara Zapała, Robert Chrzan, Aleksander Garlicki, Tomasz Mach, Aldona Dembińska-Kieć
• Journal: Advances in clinical and experimental medicine : official organ Wroclaw Medical University (Adv Clin Exp Med) 2014 Jul-Aug Vol. 23 Issue 4 Pg. 539-49 ISSN: 1899-5276 [Print] Poland
• PMID: 25166438 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Retroviral Agents
• Fatty Acids, Nonesterified
• Triglycerides

Topics

• Anti-Retroviral Agents (adverse effects)
• Body Composition (drug effects)
• Fatty Acids, Nonesterified (blood)
• Follow-Up Studies
• Humans
• Insulin Resistance
• Metabolic Diseases (etiology)
• Pilot Projects
• Tomography, X-Ray Computed
• Triglycerides (blood)