Metabolic Effects of Rosiglitazone in HIV Lipodystrophy

Hadigan, Colleen; Yawetz, Sigal; Thomas, Abraham; Havers, Fiona; Sax, Paul E.; Grinspoon, Steven

doi:10.7326/0003-4819-140-10-200405180-00008

Cited by 197 publications

(154 citation statements)

References 52 publications

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“…Regarding fat redistribution the initially encouraging results reporting a beneficial effect of rosiglitazone in body fat gain [129,130] were not seen during two other studies including a recent larger (n=108) placebo controlled study [131] evaluating rosiglitazone in lipoatrophic HIV patients [131,132] . This has led to the speculation that rosiglitazone may exert its insulin sensitizing effects without increasing the subcutaneous adipose tissue mass [132] .…”

Section: Therapeutic Implications Of the Adipokine Rolementioning

confidence: 93%

“…Indeed rosiglitazone has been shown to improve insulin resistance in patients with HIV associated metabolic syndrome, however at the expense of increased triglyceride and cholesterol concentrations [129][130][131][132] . Regarding fat redistribution the initially encouraging results reporting a beneficial effect of rosiglitazone in body fat gain [129,130] were not seen during two other studies including a recent larger (n=108) placebo controlled study [131] evaluating rosiglitazone in lipoatrophic HIV patients [131,132] .…”

Section: Therapeutic Implications Of the Adipokine Rolementioning

confidence: 99%

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Leptin and Adiponectin in the HIV Associated Metabolic Syndrome: Physiologic and Therapeutic Implications

Tsiodras¹,

Mantzoros²

2006

American J. of Infectious Diseases

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Leptin and adiponectin represent two newly discovered adipose tissue derived hormones with important roles in energy homeostasis and insulin resistance. Their interrelations with the manifestations of the HIV associated metabolic syndrome and specific somatomorphic changes i.e. fat redistribution is reviewed. A synopsis of published studies is presented and the potential role of leptin and adiponectin is discussed. We have described an association of the HIV metabolic syndrome with a state of reduced insulin sensitivity due to adiponectin deficiency. The metabolic syndrome is also accompanied by leptin deficiency in lipoatrophic subjects and possibly by a leptin resistance state in lipohypertrophic patients. Adiponectin and / or leptin therapy in a manner similar to other leptin deficiency states may assist in the future management of such patients.

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Section: Therapeutic Implications Of the Adipokine Rolementioning

confidence: 93%

Section: Therapeutic Implications Of the Adipokine Rolementioning

confidence: 99%

Leptin and Adiponectin in the HIV Associated Metabolic Syndrome: Physiologic and Therapeutic Implications

Tsiodras¹,

Mantzoros²

2006

American J. of Infectious Diseases

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“…Although insulin levels improved in both studies, subcutaneous fat did not increase. In contrast, Hadigan et al [23] performed a randomized, placebo-controlled study of HIV-infected patients with insulin resistance and fat atrophy. Hadigan et al demonstrated improved insulin sensitivity using the hyperinsulinemic euglycemic clamp procedure and a 24% increase in mid thigh extremity fat as determined by cross-sectional CT scan.…”

Section: Prevalence Of Impaired Glucose Tolerance and Diabetes Mellitusmentioning

confidence: 99%

“…In addition, adiponectin increased significantly, as also shown by Carr et al [22] . Of note, rosiglitazone was associated with an increase in LDL in the three randomized studies performed to date [21][22][23] . This effect has been previously demonstrated in non HIV-infected patients receiving thiazolidinediones and may be improved with use of other agents including pioglitazone, or in combination with lipid lowering therapy.…”

Section: Prevalence Of Impaired Glucose Tolerance and Diabetes Mellitusmentioning

confidence: 99%

“…Other studies suggest that such agents may decrease liver fat and improve liver function [21] . Three randomized, placebo-controlled trials of rosiglitazone in HIV-infected patients have recently been published [21][22][23] . Sutinen and Carr et al [21,22] studied HIV-infected patients with evidence of fat atrophy, but did not a priori select patients for insulin resistance.…”

Section: Prevalence Of Impaired Glucose Tolerance and Diabetes Mellitusmentioning

confidence: 99%

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Abnormal Glucose Regulation and Treatment Strategies for Insulin Resistance HIV-Infected Patients

Grinspoon¹

2006

American J. of Infectious Diseases

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HIV-infected patients receiving highly active antiretroviral therapy often demonstrate abnormalities in glucose regulation, in association with changes in fat distribution [1,2] . In the majority of cases, these abnormalities are best characterized by insulin resistance and impaired glucose tolerance, rather than overt diabetes mellitus and fasting hyperglycemia. Insulin resistance may result from direct effects of antiretroviral therapy, changes in fat distribution or abnormal regulation of fat metabolism and adipocytokines. Use of insulin sensitizing agents may be rationale to reduce cardiovascular risk and improve related metabolic and body fat abnormalities in HIV-infected patients.

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Growth Hormone–Releasing Hormone in HIV-Infected Men With Lipodystrophy

Koutkia

Canavan²,

Breu³

et al. 2004

JAMA

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ciency virus (HIV) lipodystrophy syndrome is highly prevalent among patients receiving antiretroviral therapy. 1 Although heterogeneous in its presentation, the syndrome is often characterized by excessive truncal and visceral adiposity, subcutaneous and extremity fat loss, 2 and metabolic abnormalities including hypertriglyceridemia, reduced highdensity lipoprotein cholesterol levels, and insulin resistance, which may increase risk of coronary artery disease. 3,4 Cross-sectional studies do not uniformly show an association between lipodystrophy and antiretroviral therapy, 5 but longitudinal cohort studies suggest that protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs) may be associated with loss of peripheral fat. 6 Prospective studies of body composition in antiretroviral-naive individuals suggest loss of extremity fat and gain in truncal fat with institution of highly active antiretroviral therapy. 7 In a randomized study of antiretroviral-naive individuals initiating antiretroviral therapy, use of a stavudine-containing regimen was associated with a greater

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Metabolic Effects of Rosiglitazone in HIV Lipodystrophy

Cited by 197 publications

References 52 publications

Leptin and Adiponectin in the HIV Associated Metabolic Syndrome: Physiologic and Therapeutic Implications

Leptin and Adiponectin in the HIV Associated Metabolic Syndrome: Physiologic and Therapeutic Implications

Abnormal Glucose Regulation and Treatment Strategies for Insulin Resistance HIV-Infected Patients

Growth Hormone–Releasing Hormone in HIV-Infected Men With Lipodystrophy

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