Increased rates of lipolysis among human immunodeficiency virus[ndash ]infected men receiving highly active antiretroviral therapy

Hadigan, Colleen; Borgonha, Sudhir; Rabe, Jessica; Young, Vernon R.; Grinspoon, Steven

doi:10.1053/meta.2002.34704

Cited by 140 publications

(99 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, the cumulative exposure to HAART, as well as the cumulative exposure to individual drug classes (nucleosides, NNRTIs, protease inhibitors) revealed no significant association with either brachial FMD or CIMT. Studies have also found an association between thymidine analogue use and insulin resistance [20][21][22], but in the present study there was no significant correlation between cumulative exposure/use ever of zidovudine or stavudine and HOMA-IR/Belfiore index, brachial FMD, or CIMT. There have also been conflicting data with regard to effects of body fat changes (lipoatrophy) on FMD [13,23], but in our study we found no significant association between appendicular fat, trunk fat, or trunk/limb fat ratio and FMD.…”

Section: Predictors Of Flow-mediated Vasodilation and Carotid Intima-contrasting

confidence: 89%

“…Although we did not find a significant association between current protease inhibitor or thymidine analogue use and insulin resistance, brachial FMD, or CIMT, the use of specific antiretrovirals has been strongly associated with insulin resistance in other studies [3,4,[20][21][22]27,28]. The development of insulin resistance in some patients on HAART may have important long-term implications in determining cardiovascular disease risk.…”

Section: Discussioncontrasting

confidence: 63%

See 1 more Smart Citation

Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term highly active antiretroviral therapy

Mondy

Fuentes²,

Önen³

et al. 2008

Aids

View full text Add to dashboard Cite

Objective-Cardiovascular disease risk among persons with HIV is likely multifactorial, thus testing a variety of available noninvasive vascular ultrasound and other surrogate tests may yield differing results. To address this issue, we assessed multiple metabolic and clinical predictors of endothelial function and carotid intima-media thickness in HIV-infected subjects and compared results with HIV-negative controls.Design-Prospective, cross-sectional study of 50 HIV-infected, healthy adults on stable highly active antiretroviral therapy matched to 50 HIV-negative controls by age, sex, race, and body mass index.Methods-Flow-mediated vasodilation of the brachial artery, carotid intima-media thickness, dual energy X-ray absorptiometry (HIV-infected subjects), and fasting insulin, lipids, and oral glucose tolerance tests were performed. Results were compared between HIV-infected and control groups.Results-Fifty percent of subjects were African-American with 34% women. Among HIVinfected, mean CD4 cell count was 547 cells/ µl; 90% had HIV RNA less than 50 copies/ml. There were no significant differences between HIV-infected and control subjects with regard to brachial artery flow-mediated vasodilation or carotid intima-media thickness. In multivariate analyses of the HIV cohort, independent predictors of endothelial dysfunction (lower flow-mediated vasodilation) were increasing insulin resistance, greater alcohol consumption, and higher baseline brachial artery diameter (P < 0.05); predictors of increased carotid intima-media thickness were hypertension, higher trunk/limb fat ratio, and insulin resistance (P < 0.05).Conclusion-In this HIV cohort on modern highly active antiretroviral therapy with well controlled HIV, there were no significant differences with regard to preclinical markers of cardiovascular disease. Insulin resistance was a strong predictor of impaired brachial artery flowmediated vasodilation and increased carotid intima-media thickness, and may be an important cardiovascular disease risk factor in the HIV population.

show abstract

Section: Predictors Of Flow-mediated Vasodilation and Carotid Intima-contrasting

confidence: 89%

Section: Discussioncontrasting

confidence: 63%

Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term highly active antiretroviral therapy

Mondy

Fuentes²,

Önen³

et al. 2008

Aids

View full text Add to dashboard Cite

show abstract

“…104 This appears to be due to enhanced lipolysis in adipose tissue, an expected event considering the progressive loss of fat in lipoatrophic adipose depots. The increased levels of FFAs play an important role in the insulin resistance appearing in HALS, and lipolysis inhibition attained through pharmacological means has been reported to ameliorate insulin sensitivity in HALS patients.…”

Section: The Paradox Of the Common Inflammation Status In Adipose Tismentioning

confidence: 99%

Lipodystrophy in HIV 1-infected patients: lessons for obesity research

2007

View full text Add to dashboard Cite

“…Metabolically, the syndrome is characterized by insulin resistance (3,4), impaired glucose tolerance (5,6) and hepatic insulin resistance (7). Also, fat metabolism is disturbed with reports on increased lipolysis (8), increased fat deposition in the liver (9) and muscle tissue (10,11), increased expression of tumour necrosis factor-a in fat tissue and decreased plasma levels of adiponectin (12). The subcutaneous fat atrophy in the leg region has been positively related to a high level of fasting insulin and fasting C-peptide, indicating a relationship between insulin resistance and fat distribution (5,13).…”

Section: Introductionmentioning

confidence: 99%

Defective glucose and lipid metabolism in human immunodeficiency virus-infected patients with lipodystrophy involve liver, muscle tissue and pancreatic β-cells

et al. 2005

View full text Add to dashboard Cite

Objectives: Lipodystrophy and insulin resistance are prevalent among human immunodeficiency virus (HIV)-infected patients on combined antiretroviral therapy (HAART). Aiming to provide a detailed description of the metabolic adverse effects of HIV-lipodystrophy, we investigated several aspects of glucose metabolism, lipid metabolism and b-cell function in lipodystrophic HIV-infected patients. Methods: [3-3 H]glucose was applied during euglycaemic hyperinsulinaemic clamps in association with indirect calorimetry in 43 normoglycaemic HIV-infected patients (18 lipodystrophic patients on HAART (LIPO), 18 patients without lipodystrophy on HAART (NONLIPO) and seven patients who were naïve to antiretroviral therapy (NAÏVE) respectively). b-cell function was evaluated by an intravenous glucose tolerance test. Results: Compared with NONLIPO and NAÏVE separately, LIPO displayed markedly reduced ratio of limb to trunk fat (RLF; . 34%, P , 0.001), hepatic insulin sensitivity (. 40%, P , 0.03), incremental glucose disposal (. 50%, P , 0.001) and incremental exogenous glucose storage (. 50%, P , 0.05). Furthermore, LIPO displayed reduced incremental glucose oxidation (P , 0.01), increased clamp free fatty acids (P , 0.05) and attenuated insulin-mediated suppression of lipid oxidation (P , 0.05) compared with NONLIPO. In combined study groups, RLF correlated with hepatic insulin sensitivity (r ¼ 0.69), incremental glucose disposal (r ¼ 0.71) and incremental exogenous glucose storage (r ¼ 0.40), all P , 0.01. Disposition index (i.e. first-phase insulin response to intravenous glucose multiplied by incremental glucose disposal) was reduced by 46% (P ¼ 0.05) in LIPO compared with the combined groups of NONLIPO and NAÏVE, indicating an impaired adaptation of b-cell function to insulin resistance in LIPO. Conclusion: Our data suggest that normoglycaemic lipodystrophic HIV-infected patients display impaired glucose and lipid metabolism in multiple pathways involving liver, muscle tissue and b-cell function.

show abstract

Increased rates of lipolysis among human immunodeficiency virus[ndash ]infected men receiving highly active antiretroviral therapy

Cited by 140 publications

References 12 publications

Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term highly active antiretroviral therapy

Insulin resistance predicts endothelial dysfunction and cardiovascular risk in HIV-infected persons on long-term highly active antiretroviral therapy

Lipodystrophy in HIV 1-infected patients: lessons for obesity research

Defective glucose and lipid metabolism in human immunodeficiency virus-infected patients with lipodystrophy involve liver, muscle tissue and pancreatic β-cells

Contact Info

Product

Resources

About