Melvin A J, Lennon S, Mohan K M, Purnell J Q
Division of Pediatric Infectious Disease, Department of Pediatrics, University of Washington, Seattle, Washington 98105, USA.
AIDS Res Hum Retroviruses. 2001 Aug 10;17(12):1117-23. doi: 10.1089/088922201316912727.
Our objective was to determine whether HIV-infected children treated with protease inhibitors (PIs) have different blood lipid, insulin, and glucose levels and body composition than HIV-infected children not treated with PIs. A cross-sectional cohort study was performed; in which 23 children were treated with combination antiretroviral therapy including a PI for at least 6 months and 12 children were treated with nucleoside reverse transcriptase inhibitors only (no-PI group). Levels of lipids, apolipoprotein B (apoB), insulin, and glucose were determined in the fasting state. Body composition and fat distribution were determined by anthropometric measurements and dual energy X-ray absorptiometry (DEXA) scan. Total cholesterol levels were higher in the PI-treated children (5.33 +/- 0.87 mM) than in the no-PI children (3.69 +/- 0.59 mM) (p < 0.0001). Similarly, low-density lipoprotein (LDL) levels were also elevated in the PI-treated children (3.27 +/- 0.76 vs. 2.14 +/- 0.51 mM) (p < 0.0001). ApoB and high-density lipoprotein (HDL), and to a lesser degree triglyceride levels, were also increased in the PI-treated children. Apart from percent arm fat as measured by DEXA, there were no differences between the two groups in measures of body composition or in their fasting glucose and insulin levels. The results from this cross-sectional cohort study suggest that the predominant lipid abnormalities associated with treatment with combination antiretroviral therapy including a PI in HIV-1-infected children are elevated total and LDL cholesterol.
我们的目的是确定接受蛋白酶抑制剂（PIs）治疗的HIV感染儿童与未接受PIs治疗的HIV感染儿童相比，其血脂、胰岛素、血糖水平及身体成分是否存在差异。我们进行了一项横断面队列研究，其中23名儿童接受了包括一种PI的联合抗逆转录病毒治疗至少6个月，12名儿童仅接受核苷类逆转录酶抑制剂治疗（无PI组）。在空腹状态下测定血脂、载脂蛋白B（apoB）、胰岛素和血糖水平。通过人体测量和双能X线吸收法（DEXA）扫描确定身体成分和脂肪分布。接受PI治疗的儿童总胆固醇水平（5.33±0.87 mM）高于无PI组儿童（3.69±0.59 mM）（p<0.0001）。同样，接受PI治疗的儿童低密度脂蛋白（LDL）水平也升高（3.27±0.76 vs. 2.14±0.51 mM）（p<0.0001）。接受PI治疗的儿童apoB和高密度脂蛋白（HDL）以及甘油三酯水平也有一定程度的升高。除了通过DEXA测量的手臂脂肪百分比外，两组在身体成分测量或空腹血糖和胰岛素水平方面没有差异。这项横断面队列研究的结果表明，在HIV-1感染儿童中，与包括PI的联合抗逆转录病毒治疗相关的主要脂质异常是总胆固醇和LDL胆固醇升高。
