Lee Grace A, Rao Madhu N, Grunfeld Carl
Department of Veterans Affairs Medical Center, Metabolism Section (Box 111F), 4150 Clement Street, San Francisco, CA 94121, USA.
Curr HIV/AIDS Rep. 2005 Feb;2(1):39-50. doi: 10.1007/s11904-996-0008-z.
Since the introduction of HIV protease inhibitors (PIs), disorders of glucose and lipid metabolism have emerged. In dissecting out the direct effect on lipid and glucose metabolism, it has become apparent that individual PIs have different effects on metabolism. Some PIs such as indinavir acutely induce insulin resistance. PIs have also been shown to cause other disorders of glucose metabolism, including impairment of insulin secretion and increased endogenous glucose production. Individual PIs also have different effects on lipid metabolism. Ritonavir predominantly increases triglyceride and very low-density lipoprotein cholesterol levels. Limited studies in HIV-negative volunteers suggest that several of the PIs do not increase low-density lipoprotein cholesterol levels. This review examines the direct effects of PIs on glucose and lipid metabolism by assessing prospective studies of HIV-infected and healthy normal volunteers, and in vitro studies.
自引入HIV蛋白酶抑制剂（PIs）以来，已出现葡萄糖和脂质代谢紊乱。在剖析对脂质和葡萄糖代谢的直接影响时，很明显不同的PI对代谢有不同的作用。一些PI，如茚地那韦，可急性诱导胰岛素抵抗。PI还被证明会导致其他葡萄糖代谢紊乱，包括胰岛素分泌受损和内源性葡萄糖生成增加。不同的PI对脂质代谢也有不同的作用。利托那韦主要会使甘油三酯和极低密度脂蛋白胆固醇水平升高。在HIV阴性志愿者中进行的有限研究表明，几种PI不会使低密度脂蛋白胆固醇水平升高。本综述通过评估对HIV感染者和健康正常志愿者的前瞻性研究以及体外研究，来探讨PI对葡萄糖和脂质代谢的直接影响。
