Andersen Ove, Eugen-Olsen Jesper, Kofoed Kristian, Iversen Johan, Haugaard Steen B
Department of Infectious Diseases, Copenhagen University, Hvidovre Hospital, DK 2650 Hvidovre, Copenhagen, Denmark.
J Infect. 2008 Jul;57(1):55-63. doi: 10.1016/j.jinf.2008.01.014. Epub 2008 Mar 6.
We have recently shown that the level of soluble urokinase plasminogen activator receptor (suPAR), which is associated with the immune status of HIV-infected patients undergoing highly active antiretroviral therapy (HAART), correlates with the insulin action of such patients. Here we extend these findings by investigating the association of suPAR to glucose metabolic insufficiency during an oral glucose challenge (OGTT).
In 16 HIV-infected patients with lipodystrophy and 15 HIV-infected patients without lipodystrophy, glucose tolerance, insulin sensitivity (ISI(composite)), prehepatic insulin secretion, proinsulin level and suppression of free fatty acids (FFA) were determined during an OGTT. Stability of suPAR was tested in 6 HIV-infected patients during a 3h OGTT.
Lipodystrophy was associated with a 70% increase in plasma suPAR (P<0.05). During the OGTT, plasma suPAR correlated inversely with ISI(composite) and positively with 2h plasma glucose, fasting insulin secretion, fasting intact proinsulin and FFA level during the OGTT (all P<0.05). In multiple regression analyses, in which anthropometric measures (BMI, limbadiposity and fat mass), immune markers (CD4, HIV-RNA, duration of HIV infection), and dyslipidemia (plasma total cholesterol, triglyceride and free fatty acid level during the OGTT) were included, suPAR remained a significant marker of glucose tolerance and insulin sensitivity. Plasma suPAR exhibited a small CV (11%) during the 3h OGTT.
suPAR associated to important glucose metabolic aberrations in HIV-infected patients on HAART. Moreover, suPAR was stable after a glucose challenge. Future research is required to confirm these findings and explore the potential of suPAR as marker of dysmetabolism in HIV-infected patients.
我们最近发现，可溶性尿激酶型纤溶酶原激活物受体（suPAR）水平与接受高效抗逆转录病毒治疗（HAART）的HIV感染患者的免疫状态相关，且与这些患者的胰岛素作用相关。在此，我们通过研究suPAR与口服葡萄糖耐量试验（OGTT）期间葡萄糖代谢不足的关联来扩展这些发现。
对16例患有脂肪代谢障碍的HIV感染患者和15例未患脂肪代谢障碍的HIV感染患者，在OGTT期间测定其葡萄糖耐量、胰岛素敏感性（ISI（综合））、肝前胰岛素分泌、胰岛素原水平以及游离脂肪酸（FFA）的抑制情况。在6例HIV感染患者的3小时OGTT期间测试suPAR的稳定性。
脂肪代谢障碍与血浆suPAR升高70%相关（P<0.05）。在OGTT期间，血浆suPAR与ISI（综合）呈负相关，与2小时血浆葡萄糖、空腹胰岛素分泌、空腹完整胰岛素原以及OGTT期间的FFA水平呈正相关（均P<0.05）。在多元回归分析中，纳入了人体测量指标（BMI、肢体脂肪分布和脂肪量）、免疫标志物（CD4、HIV-RNA、HIV感染持续时间）以及血脂异常（OGTT期间血浆总胆固醇、甘油三酯和游离脂肪酸水平），suPAR仍然是葡萄糖耐量和胰岛素敏感性的重要标志物。在3小时OGTT期间，血浆suPAR的变异系数较小（11%）。
suPAR与接受HAART的HIV感染患者重要的葡萄糖代谢异常相关。此外，葡萄糖激发后suPAR是稳定的。需要进一步的研究来证实这些发现，并探索suPAR作为HIV感染患者代谢紊乱标志物的潜力。
