生长激素和替莫瑞林在治疗HIV相关脂肪代谢障碍中的应用
Growth hormone and tesamorelin in the management of HIV-associated lipodystrophy.
作者信息
Bedimo Roger
机构信息
Infectious Disease section, VA North Texas Health Care System, TX, USA.
出版信息
HIV AIDS (Auckl). 2011;3:69-79. doi: 10.2147/HIV.S14561. Epub 2011 Jul 10.
Abstract
HIV-infected patients on highly active antiretroviral therapy (HAART) develop a complex of body composition changes known, including peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). These changes may cause significant patient distress, which could in turn interfere with adherence to antiretroviral therapy. Treatment options - including antiretroviral switch, insulin sensitizers, and surgical approaches - have been associated with limited success and potential complications. The observation that low growth hormone levels are associated with central fat accumulation among HIV patients has led to the development of tesamorelin (a growth hormone releasing hormone analog) for the management of central fat accumulation. Randomized controlled trials have shown that administration of tesamorelin is safe and effective in reducing central fat accumulation among HIV-infected patients. This effect is transient, however, and its association with improved cardiovascular risk remains unclear.
摘要
接受高效抗逆转录病毒治疗（HAART）的HIV感染患者会出现一系列已知的身体成分变化，包括外周脂肪减少（脂肪萎缩）和中心性脂肪堆积（脂肪肥大）。这些变化可能会给患者带来极大困扰，进而影响对抗逆转录病毒治疗的依从性。治疗选择——包括更换抗逆转录病毒药物、使用胰岛素增敏剂以及手术方法——取得的成功有限且存在潜在并发症。有观察发现，HIV患者生长激素水平低与中心性脂肪堆积有关，这促使研发了替莫瑞林（一种生长激素释放激素类似物）来治疗中心性脂肪堆积。随机对照试验表明，给予替莫瑞林对减少HIV感染患者的中心性脂肪堆积是安全有效的。然而，这种效果是短暂的，其与心血管风险改善之间的关联仍不明确。
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