Albu Jeanine B, Kenya Sonjia, He Qing, Wainwright Marsha, Berk Evan S, Heshka Stanley, Kotler Donald P, Engelson Ellen S
Endocrine, Diabetes and Nutrition Division, the New York Obesity Research Center, St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Am J Clin Nutr. 2007 Jul;86(1):100-6. doi: 10.1093/ajcn/86.1.100.
Obesity and insulin resistance are growing problems in HIV-positive (HIV+) women receiving highly active antiretroviral therapy (HAART).
The objective was to determine the contribution of adipose tissue (AT) enlargement and distribution to the presence of insulin resistance in obese HIV+ women.
Whole-body intermuscular AT (IMAT), visceral AT (VAT), subcutaneous AT (SAT), and SAT distribution (leg versus upper body) were measured by whole-body magnetic resonance imaging. Insulin sensitivity (S(I)) was measured with an intravenous glucose tolerance test in obese HIV+ women recruited because of their desire to lose weight (n=17) and in obese healthy controls (n=32).
The HIV+ women had relatively less whole-body SAT and more VAT and IMAT than did the controls (P<0.05 for all). A significant interaction by HIV status was observed for the relation of total SAT with S(I) (P<0.001 for the regression's slope interactions after adjustment for age, height, and weight). However, relations of IMAT, VAT, and SAT distribution (leg SAT as a percentage of total SAT; leg SAT%) with S(I) did not differ significantly between groups. For both groups combined, the best model predicting a low S(I) included significant contributions by both high IMAT and low leg SAT%, independent of age, height, and weight, and no interaction between groups was observed (overall r(2)=0.44, P=0.0003).
In obese HIV+ women, high whole-body IMAT and low leg SAT% distribution are independently associated with insulin resistance.
肥胖和胰岛素抵抗在接受高效抗逆转录病毒治疗（HAART）的HIV阳性（HIV+）女性中日益成为问题。
确定肥胖的HIV+女性中脂肪组织（AT）增大和分布对胰岛素抵抗存在的影响。
通过全身磁共振成像测量全身肌间AT（IMAT）、内脏AT（VAT）、皮下AT（SAT）以及SAT分布（腿部与上身）。对因希望减肥而招募的肥胖HIV+女性（n = 17）和肥胖健康对照者（n = 32）进行静脉葡萄糖耐量试验以测量胰岛素敏感性（S(I)）。
与对照组相比，HIV+女性的全身SAT相对较少，VAT和IMAT较多（所有P<0.05）。在调整年龄、身高和体重后，观察到总SAT与S(I)的关系存在HIV状态的显著交互作用（回归斜率交互作用P<0.001）。然而，IMAT、VAT和SAT分布（腿部SAT占总SAT的百分比；腿部SAT%）与S(I)的关系在两组之间无显著差异。对于两组合并分析，预测低S(I)的最佳模型包括高IMAT和低腿部SAT%的显著贡献，独立于年龄、身高和体重，且未观察到组间交互作用（总体r(2)=0.44，P = 0.0003）。
在肥胖的HIV+女性中，高全身IMAT和低腿部SAT%分布与胰岛素抵抗独立相关。
