Barb Diana, Wadhwa Sanjivini G, Kratzsch Juergen, Gavrila Alina, Chan Jean L, Williams Catherine J, Karchmer Adolf W, Mantzoros Christos S
Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Stoneman 816, Boston, Massachusetts 02215, USA.
J Clin Endocrinol Metab. 2005 Sep;90(9):5324-8. doi: 10.1210/jc.2005-0742. Epub 2005 Jun 14.
The mechanisms underlying the development of the highly active antiretroviral therapy (HAART)-induced metabolic syndrome remain to be fully elucidated.
The objective of this study was to investigate whether the adipocyte-secreted hormone, resistin, is associated with anthropometric and metabolic abnormalities of the HAART-induced metabolic syndrome.
DESIGN, SETTING, AND PATIENTS: We conducted a cross-sectional study of 227 HIV-positive patients (37 women and 190 men) recruited from the infectious diseases clinics. On the basis of history, physical examination, dual-energy x-ray absorptiometry, and single-slice computed tomography, patients were classified into four groups: non-fat redistribution (n = 85), fat accumulation (n = 42), fat wasting (n = 35), and mixed fat redistribution (n = 56).
The main outcome measures were serum resistin levels and anthropometric and metabolic variables.
Mean serum resistin levels were not significantly different among subjects with fat accumulation, fat wasting, or mixed fat redistribution or between these groups and the non-fat redistribution group. We found a weak, but significant, positive correlation between resistin and percent total body fat (r = 0.20; P < 0.01), total extremity fat (r = 0.18; P < 0.01), and abdominal sc fat (r = 0.19; P < 0.01), but not abdominal visceral fat (r = -0.10; P = 0.16) or waist to hip ratio (r = -0.05; P = 0.43). When adjustments were made for gender (women, 3.92 +/- 2.71 ng/ml; men, 2.96 +/- 2.61 ng/ml; P = 0.05), correlations between resistin and the above parameters were no longer significant. Importantly, resistin levels were not correlated with fasting glucose, insulin, homeostasis model assessment of insulin resistance index, triglycerides, or cholesterol levels in the whole group.
Resistin is related to gender, but is unlikely to play a major role in the insulin resistance and metabolic abnormalities of the HAART-induced metabolic syndrome.
高效抗逆转录病毒疗法(HAART)诱导的代谢综合征的发病机制仍有待充分阐明。
本研究旨在调查脂肪细胞分泌的激素抵抗素是否与HAART诱导的代谢综合征的人体测量和代谢异常有关。
设计、地点和患者:我们对从传染病诊所招募的227名HIV阳性患者(37名女性和190名男性)进行了横断面研究。根据病史、体格检查、双能X线吸收法和单层计算机断层扫描,将患者分为四组:非脂肪重新分布组(n = 85)、脂肪堆积组(n = 42)、脂肪消耗组(n = 35)和混合性脂肪重新分布组(n = 56)。
主要观察指标为血清抵抗素水平以及人体测量和代谢变量。
脂肪堆积组、脂肪消耗组或混合性脂肪重新分布组患者之间以及这些组与非脂肪重新分布组之间的平均血清抵抗素水平无显著差异。我们发现抵抗素与全身脂肪百分比(r = 0.20;P < 0.01)、四肢总脂肪(r = 0.18;P < 0.01)和腹部皮下脂肪(r = 0.19;P < 0.01)之间存在微弱但显著的正相关,但与腹部内脏脂肪(r = -0.10;P = 0.16)或腰臀比(r = -0.05;P = 0.43)无关。在对性别进行校正后(女性,3.92±2.71 ng/ml;男性,2.96±2.61 ng/ml;P = 0.05),抵抗素与上述参数之间的相关性不再显著。重要的是,整个组中抵抗素水平与空腹血糖、胰岛素、胰岛素抵抗指数的稳态模型评估、甘油三酯或胆固醇水平无关。
抵抗素与性别有关,但不太可能在HAART诱导的代谢综合征的胰岛素抵抗和代谢异常中起主要作用。