Røge Birgit T, Calbet José A L, Møller Kirsten, Ullum Henrik, Hendel Helle W, Gerstoft Jan, Pedersen Bente K
Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
AIDS. 2002 May 3;16(7):973-82. doi: 10.1097/00002030-200205030-00003.
To investigate the skeletal muscle mitochondrial function in HIV-infected patients with lipodystrophy or elevated p-lactate levels.
Eight HIV patients treated with highly active antiretroviral therapy, with lipodystrophy or elevated p-lactate, and eight healthy controls were exposed to incremental exercise until exhaustion.
Blood samples and gas analysis were performed at rest, during exercise and in recovery. Oxygen consumption, workload and blood lactate were assessed. Before and immediately after exercise muscle biopsies were obtained, in which citrate synthase (CS), hydroxyacyl-coenzyme A dehydrogenase (HD), glycogen and nucleotides were measured.
Maximal workload was significantly lower in patients compared with controls [171 Watt (88-206) versus 235 Watt (118-294) P = 0.05]. A trend towards lower maximal oxygen consumption (VO(2max)) was detected in patients [2136 ml/min (1221-2598) versus 2985 ml/min (1506-3959) P = 0.11]. Patients had significantly elevated levels of blood lactate at rest [1.55 mmol/l (1-2.5) versus 0.8 mmo/l (0.37-1.1) P < 0.01), but no significant difference in maximal blood-lactate values was found. The decline in blood lactate in the recovery period was similar between groups. There was no significant difference in CS, HD, glycogen or nucleotides.
The significantly lower working capacity and the trend towards reduced VO(2max) in patients could be caused by mitochondrial dysfunction, but may also be caused by impaired physical fitness. The similar levels of nucleotides, CS, HD, and glycogen and the normal increase in blood lactate during exercise indicates a normal oxidative phosphorylation. No evidence of serious damage to skeletal muscle mitochondrial function was found.
研究合并脂肪代谢障碍或血β-乳酸水平升高的HIV感染患者的骨骼肌线粒体功能。
选取8例接受高效抗逆转录病毒治疗、合并脂肪代谢障碍或血β-乳酸水平升高的HIV患者以及8名健康对照者，进行递增负荷运动直至力竭。
在静息状态、运动过程中和恢复过程中采集血样并进行气体分析。评估耗氧量、工作量和血乳酸水平。在运动前和运动后即刻获取肌肉活检样本，检测其中的柠檬酸合酶（CS）、羟酰基辅酶A脱氢酶（HD）、糖原和核苷酸水平。
与对照组相比，患者的最大工作量显著降低[171瓦（88 - 206）vs 235瓦（118 - 294），P = 0.05]。检测发现患者的最大耗氧量（VO₂max）有降低趋势[2136毫升/分钟（1221 - 2598）vs 2985毫升/分钟（1506 - 3959），P = 0.11]。患者静息时血乳酸水平显著升高[1.55毫摩尔/升（1 - 2.5）vs 0.8毫摩尔/升（0.37 - 1.1），P < 0.01]，但最大血乳酸值无显著差异。两组在恢复期血乳酸的下降情况相似。CS、HD、糖原或核苷酸水平无显著差异。
患者工作能力显著降低以及VO₂max有降低趋势可能是由线粒体功能障碍所致，但也可能是由身体素质下降引起。核苷酸、CS、HD和糖原水平相似以及运动过程中血乳酸正常升高表明氧化磷酸化正常。未发现骨骼肌线粒体功能严重受损的证据。
