Markedly diminished lipolysis and partial restoration of glucose metabolism, without changes in fat distribution after extended discontinuation of protease inhibitors in severe lipodystrophic human immunodeficient virus-1-infected patients

The Journal of Clinical Endocrinology and Metabolism
Marc van der ValkPeter Reiss

Abstract

Treatment for HIV-1 infection is often complicated by a lipodystrophy syndrome associated with insulin resistance and an elevated rate of lipolysis. In eight HIV-1 infected men with lipodystrophy syndrome, we studied the effects of replacement of protease inhibitor (PI) by abacavir on insulin sensitivity and lipolysis by hyperinsulinemic euglycemic clamp and on fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan. Glucose metabolism and lipolysis were assessed by tracer dilution employing [6,6-(2)H(2)]glucose and [(2)H(5)]glycerol, respectively. Data are expressed as mean +/- sd or 95% confidence interval (CI), as appropriate. There were no significant changes in fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan at wk 36 and wk 96. The fasting total glucose production decreased from 16.1 +/- 2.5 at study entry by 1.1 (range, -2.1 to -0.1) to 15.0 +/- 1.5 micromol/kg.min after PI withdrawal at wk 36 (n = 8). In an analysis restricted to the patients on treatment at wk 96 (n = 6), the decrease was 0.9 (range, -2.1 to 0.3) micromol/kg.min. During insulin infusion, glucose oxidation (as percent of total glucose disposal) increased from 36.8 +/- 12.7% by ...Continue Reading

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Citations

Jul 27, 2007·International Journal of Obesity : Journal of the International Association for the Study of Obesity·F VillarroyaM Giralt
Mar 3, 2005·The Journal of Clinical Endocrinology and Metabolism·Diane C Adler-WailesJack A Yanovski
Oct 6, 2009·Biochimica Et Biophysica Acta·Francesc VillarroyaMarta Giralt
May 16, 2006·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·J OckengaUNKNOWN ESPEN (European Society for Parenteral and Enteral Nutrition)
May 11, 2006·Journal of Lipid Research·Christina Koutsari, Michael D Jensen
Jul 1, 2009·Expert Review of Clinical Pharmacology·Allison Martin, Sean Emery
Mar 19, 2008·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·Stefano BenediniLivio Luzi
Aug 20, 2009·American Journal of Physiology. Endocrinology and Metabolism·Regje M E BlümerHans P Sauerwein

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