Prasithsirikul Wisit, Bunnag Pongamorn
Bamrasnaradura Institute, Nonthaburi 11000, Thailand.
J Med Assoc Thai. 2004 Feb;87(2):166-72.
HIV-associated lipodystrophy syndrome is a syndrome occurring in HIV-infected patients who were treated with highly-active antiretroviral therapy (HAART), especially regimen containing protease inhibitors. The syndrome consists of fat redistribution, with loss of subcutaneous fat and increase in visceral fat, and metabolic disturbances, including glucose intolerance or overt diabetes and dyslipidemia. No standard treatment has been established for this syndrome. Pioglitazone is an oral antidiabetic agent that acts primarily on adipose tissue to reduce insulin resistance. The authors report a 50-year old HIV-infected woman who developed HIV-associated lipodystrophy syndrome after 3 months of HAART. She had significant weight loss with obvious loss of subcutaneous fat, together with development of hypertension, diabetes and dyslipidemia. After treatment with 30 milligrams of pioglitazone daily, her body weight increased within the first month of treatment. Subcutaneous fat loss was restored. Improvement in glycemic and lipid control was also noted. CT scan of the abdomen revealed that fatty infiltration in the liver was markedly decreased. Visceral fat as assessed by CT scan had also decreased. Pioglitazone appeared to have beneficial effects in this patient.
HIV 相关脂肪代谢障碍综合征是一种发生在接受高效抗逆转录病毒治疗（HAART）的 HIV 感染患者中的综合征，尤其是包含蛋白酶抑制剂的治疗方案。该综合征包括脂肪重新分布，即皮下脂肪减少和内脏脂肪增加，以及代谢紊乱，包括葡萄糖不耐受或显性糖尿病和血脂异常。目前尚未确立针对该综合征的标准治疗方法。吡格列酮是一种主要作用于脂肪组织以降低胰岛素抵抗的口服抗糖尿病药物。作者报告了一名 50 岁的 HIV 感染女性，在接受 HAART 治疗 3 个月后出现了 HIV 相关脂肪代谢障碍综合征。她体重显著减轻，皮下脂肪明显减少，同时出现了高血压、糖尿病和血脂异常。在每天服用 30 毫克吡格列酮治疗后，她的体重在治疗的第一个月内增加。皮下脂肪减少的情况得到恢复。血糖和血脂控制也有所改善。腹部 CT 扫描显示肝脏的脂肪浸润明显减少。通过 CT 扫描评估的内脏脂肪也减少了。吡格列酮似乎对该患者有有益作用。
