Adiponectin, Leptin and Inflammatory Markers in HIV-associated Metabolic Syndrome in Children and Adolescents

Abstract

The prevalence of MetS was similar to that observed in larger cohorts of HIV-infected patients in our setting. Adipocytokine dysregulation seems to be related to MetS in HIV-infected children. A high percentage of patients showed insulin resistance, which should be strictly monitored.

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

“…The association between an elevated BMI and hypertension persisted in models specifically looking at PLWH on cART, adjusted odds ratio of 1.46 (95% CI: 1.13‐1.87), and also among PLWH not on cART with aOR of 1.47 (95% CI: 1.00‐2.16) in agreement with other studies . Pathophysiologically, it has been posited that both HIV itself and ART can cause lipodystrophy leading to accumulation of central adiposity with deep and intricate causal links with hypertension via adipocytokines called adiponectin and leptin . Plasma concentrations of adiponectin, a potent vasodilator through elaboration of endothelial nitric oxide, has been shown to be significantly lower among PLWH with metabolic syndrome .…”

“…Pathophysiologically, it has been posited that both HIV itself and ART can cause lipodystrophy leading to accumulation of central adiposity with deep and intricate causal links with hypertension via adipocytokines called adiponectin and leptin . Plasma concentrations of adiponectin, a potent vasodilator through elaboration of endothelial nitric oxide, has been shown to be significantly lower among PLWH with metabolic syndrome . Furthermore, it has been shown that PLWH on cART have higher circulating levels of leptin, which acting via leptin receptors simultaneously trigger activation of both the renin‐angiotensin‐aldosterone pathway and the sympathetic nervous system …”

Hypertension in HIV-Infected Adults

“…The pathophysiologic mechanisms by which HIV-related dyslipidemias induce hypertension are likely related to the adipocytokines adiponectin and leptin. 77,78,79,80,81 Adiponectin, an adipose tissue-derived cytokine or “adipokine”, acts as a vasodilator by stimulating endothelial nitric oxide, 77,78,80 and thus its deficiency has been shown to be critical in the pathogenesis of obesity-related hypertension in the general population. 77 In the context of HIV infection, decreased plasma levels of adiponectin have similarly been associated with metabolic syndrome.…”

“…77 In the context of HIV infection, decreased plasma levels of adiponectin have similarly been associated with metabolic syndrome. 78,79 For instance, in a cross-sectional study of 54 HIV-infected children and adolescents, adiponectin levels were significantly lower among those with metabolic syndrome (P=0.004). 78 Similarly, in a case-control study of 285 HIV-infected individuals (226 on ART; 59 ART-naïve) stratified by metabolic syndrome, lower adiponectin levels (P<0.0001) and higher concentrations of ROS (P<0.0001) were observed in the plasma of patients with metabolic syndrome, irrespective of ART status.…”

“…78,79 For instance, in a cross-sectional study of 54 HIV-infected children and adolescents, adiponectin levels were significantly lower among those with metabolic syndrome (P=0.004). 78 Similarly, in a case-control study of 285 HIV-infected individuals (226 on ART; 59 ART-naïve) stratified by metabolic syndrome, lower adiponectin levels (P<0.0001) and higher concentrations of ROS (P<0.0001) were observed in the plasma of patients with metabolic syndrome, irrespective of ART status. 79 Notably, no studies have directly analyzed the relationship between adiponectin and hypertension in HIV infection.…”