| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Original Research Communication |
1 From the Neuroendocrine Unit (CH, JR, GM, NA, and SG) and the Program in Nutritional Metabolism (CH, GM, NA, and SG), Massachusetts General Hospital, Boston; the Clinical Research Center, Massachusetts Institute of Technology, Cambridge (JB); and Harvard Medical School, Boston (CH, GM, and SG).
Background: Fatty acid concentrations are increased in patients with HIV and fat redistribution and may contribute to insulin resistance in this population.
Objective: We determined the effects of acute inhibition of lipolysis on insulin sensitivity in HIV-infected patients with fat redistribution who were receiving a protease inhibitor.
Design: Seven HIV-infected men [age: 45 ± 2 y; body mass index (in kg/m2): 28.8 ± 1.9] with a fasting insulin concentration 
104 pmol/L (15 µIU/mL), combined visceral adiposity and peripheral lipoatrophy, and receiving a protease inhibitor were studied. Tolbutamide-modified frequently sampled intravenous-glucose-tolerance tests (FSIGTTs) were performed after randomized double-blind administration of acipimox (500 mg at -90 and 0 min), a potent inhibitor of lipolysis, and placebo. The subjects completed 2 FSIGTTs separated by 3–7 d.
Results: At baseline, fasting insulin and fatty acid concentrations were 27.6 ± 5.0 µIU/mL and 0.83 ± 0.08 mmol/L (normal range: 0.1–0.6 mmol/L), respectively. Fatty acid concentrations were significantly reduced after acipimox compared with placebo (fatty acid area under the curve: acipimox = 73 ± 8 compared with placebo = 122 ± 12 mmol · 270 min/L, P = 0.002). Acipimox treatment resulted in a significant increase in the insulin sensitivity index (acipimox = 1.63 ± 0.5 compared with placebo = 0.88 ± 0.3 x 10-4 · min-1 · µIU/mL, P = 0.015).
Conclusions: Acute inhibition of lipolysis and reduction in fatty acid concentrations are associated with improved insulin sensitivity in patients with HIV lipodystrophy and hyperinsulinemia. Further studies are needed to determine whether long-term antilipolytic strategies to reduce fatty acid concentrations may be useful in treating the metabolic disturbances associated with HIV lipodystrophy.
Key Words: Lipodystrophy • insulin resistance • fatty acids • acipimox • HIV • men
This article has been cited by other articles:
|
|
 |
|
  M. J. Carper, W. T. Cade, M. Cam, S. Zhang, A. Shalev, K. E. Yarasheski, and S. Ramanadham HIV-protease inhibitors induce expression of suppressor of cytokine signaling-1 in insulin-sensitive tissues and promote insulin resistance and type 2 diabetes mellitus Am J Physiol Endocrinol Metab, March 1, 2008; 294(3): E558 - E567. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Lindegaard, C. Frosig, A. M. W. Petersen, P. Plomgaard, S. Ditlevsen, B. Mittendorfer, G. Van Hall, J. F.P. Wojtaszewski, and B. K. Pedersen Inhibition of Lipolysis Stimulates Peripheral Glucose Uptake but Has No Effect on Endogenous Glucose Production in HIV Lipodystrophy Diabetes, August 1, 2007; 56(8): 2070 - 2077. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Falasca, M. R. Manigrasso, D. Racciatti, P. Zingariello, M. Dalessandro, C. Ucciferri, P. Mancino, M. Marinopiccoli, C. Petrarca, P. Conti, et al. Associations between Hypertriglyceridemia and Serum Ghrelin, Adiponectin, and IL-18 Levels in HIV-infected Patients. Ann. Clin. Lab. Sci., December 1, 2006; 36(1): 59 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hadigan, J. Liebau, M. Torriani, R. Andersen, and S. Grinspoon Improved Triglycerides and Insulin Sensitivity with 3 Months of Acipimox in Human Immunodeficiency Virus-infected Patients with Hypertriglyceridemia J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4438 - 4444. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Hadigan, D. Kamin, J. Liebau, S. Mazza, S. Barrow, M. Torriani, R. Rubin, S. Weise, A. Fischman, and S. Grinspoon Depot-specific regulation of glucose uptake and insulin sensitivity in HIV-lipodystrophy Am J Physiol Endocrinol Metab, February 1, 2006; 290(2): E289 - E298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Adler-Wailes, H. Liu, F. Ahmad, N. Feng, C. Londos, V. Manganiello, and J. A. Yanovski Effects of the Human Immunodeficiency Virus-Protease Inhibitor, Ritonavir, on Basal and Catecholamine-Stimulated Lipolysis J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3251 - 3261. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. B Haugaard, O. Andersen, F. Dela, J. J. Holst, H. Storgaard, M. Fenger, J. Iversen, and S. Madsbad Defective glucose and lipid metabolism in human immunodeficiency virus-infected patients with lipodystrophy involve liver, muscle tissue and pancreatic {beta}-cells Eur. J. Endocrinol., January 1, 2005; 152(1): 103 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hadigan, S. Yawetz, A. Thomas, F. Havers, P. E. Sax, and S. Grinspoon Metabolic Effects of Rosiglitazone in HIV Lipodystrophy: A Randomized, Controlled Trial Ann Intern Med, May 18, 2004; 140(10): 786 - 794. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Koutkia, G. Meininger, B. Canavan, J. Breu, and S. Grinspoon Metabolic regulation of growth hormone by free fatty acids, somatostatin, and ghrelin in HIV-lipodystrophy Am J Physiol Endocrinol Metab, February 1, 2004; 286(2): E296 - E303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Torriani, C. Hadigan, M. E. Jensen, and S. Grinspoon Psoas muscle attenuation measurement with computed tomography indicates intramuscular fat accumulation in patients with the HIV-lipodystrophy syndrome J Appl Physiol, September 1, 2003; 95(3): 1005 - 1010. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. N. Reeds, B. Mittendorfer, B. W. Patterson, W. G. Powderly, K. E. Yarasheski, and S. Klein Alterations in lipid kinetics in men with HIV-dyslipidemia Am J Physiol Endocrinol Metab, September 1, 2003; 285(3): E490 - E497. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
