Tanwani Lal K, Mokshagundam SriPrakash L
University of Louisville and Veterans Affairs Medical Center, Louisville, KY, USA.
South Med J. 2003 Feb;96(2):180-8; quiz 189. doi: 10.1097/01.SMJ.0000051731.69719.2E.
The introduction of highly active antiretroviral therapy has significantly reduced morbidity and mortality in patients infected with the human immunodeficiency virus. Treatment with antiretroviral agents--protease inhibitors in particular--has uncovered a syndrome of abnormal fat redistribution, dyslipidemia, and impaired glucose metabolism, collectively termed lipodystrophy syndrome. The cause of the syndrome seems to be multifactorial; however, its exact mechanisms have yet to be elucidated. Accelerated risk for cardiovascular disease is likely to be a major concern in these patients in the future. At this time, no clinical guidelines are available for the prevention and/or the treatment of lipodystrophy syndrome. The available treatment options range from switching the different antiretroviral drugs and lifestyle modifications to the use of pharmacologic agents to treat patients with dyslipidemia, impaired glucose tolerance and/or diabetes, and changes in body composition. This review emphasizes the clinical features, potential molecular mechanisms, and treatment options for patients infected with human immunodeficiency virus who have lipodystrophy syndrome.
高效抗逆转录病毒疗法的引入显著降低了人类免疫缺陷病毒感染者的发病率和死亡率。使用抗逆转录病毒药物（尤其是蛋白酶抑制剂）进行治疗后，发现了一种脂肪重新分布异常、血脂异常和糖代谢受损的综合征，统称为脂肪代谢障碍综合征。该综合征的病因似乎是多因素的；然而，其确切机制尚未阐明。心血管疾病风险加速可能是这些患者未来的一个主要担忧。目前，尚无针对脂肪代谢障碍综合征预防和/或治疗的临床指南。现有的治疗选择包括更换不同的抗逆转录病毒药物、改变生活方式，以及使用药物治疗血脂异常、糖耐量受损和/或糖尿病患者以及身体成分改变的患者。这篇综述强调了患有脂肪代谢障碍综合征的人类免疫缺陷病毒感染者的临床特征、潜在分子机制和治疗选择。
