Pujol R M, Domingo P, Francia E, Sanbeat M A, Alomar A, Vazquez G
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
J Am Acad Dermatol. 2000 Feb;42(2 Pt 1):193-8. doi: 10.1016/S0190-9622(00)90125-7.
A novel type of acquired partial lipodystrophy resulting from chronic treatment with HIV-1 protease inhibitor drugs has recently been described.
We studied the clinical and histopathologic features of a series of patients with HIV-1 protease inhibitor-associated lipodystrophy to evaluate the frequency of associated abnormalities.
The study group consisted of 14 consecutive HIV-infected patients receiving treatment with HIV-1 protease inhibitors, who experienced partial lipodystrophy. Clinical (including anthropometric data) and histopathologic findings, as well as biochemical and virologic data, were evaluated.
A significant loss of fat in the face and extremities was associated with fat deposition on the abdomen, breast, and dorsocervical fat pad. Central obesity was frequently present. Histopathologic features disclosed a peculiar type of involutional lipodystrophy. Hypertriglyceridemia was detected in 78.5% of patients. Low serum levels of cholesterol-high-density lipoprotein and high cholesterol-very-low-density lipoprotein were noted. Hyperglycemia, hypercholesterolemia, or hyperinsulinemia were occasionally detected.
HIV-1 protease inhibitor-associated lipodystrophy represents a new entity with peculiar clinical and histopathologic features. Metabolic associated abnormalities may imply a risk of future atherogenic complications.
最近描述了一种由长期使用HIV-1蛋白酶抑制剂药物引起的新型获得性部分脂肪营养不良。
我们研究了一系列与HIV-1蛋白酶抑制剂相关的脂肪营养不良患者的临床和组织病理学特征，以评估相关异常的发生率。
研究组由14例连续接受HIV-1蛋白酶抑制剂治疗且出现部分脂肪营养不良的HIV感染患者组成。对临床（包括人体测量数据）、组织病理学结果以及生化和病毒学数据进行了评估。
面部和四肢脂肪明显减少，同时伴有腹部、乳房和颈背脂肪垫脂肪沉积。经常出现中心性肥胖。组织病理学特征显示为一种特殊类型的退化性脂肪营养不良。78.5%的患者检测到高甘油三酯血症。观察到血清中高密度脂蛋白胆固醇水平低和极低密度脂蛋白胆固醇水平高。偶尔检测到高血糖、高胆固醇血症或高胰岛素血症。
与HIV-1蛋白酶抑制剂相关的脂肪营养不良是一种具有特殊临床和组织病理学特征的新病症。代谢相关异常可能意味着未来发生动脉粥样硬化并发症的风险。
