Arama V, Munteanu D I, Streinu Cercel A, Ion D A, Mihailescu R, Tiliscan C, Tudor A M, Arama S S
National Institute of Infectious Diseases, No 1Grozovici Street, 021105, Bucharest, Romania.
J Endocrinol Invest. 2014 Jun;37(6):533-9. doi: 10.1007/s40618-014-0057-x. Epub 2014 Feb 15.
Impaired production of adipocytokines is a major factor incriminated in the occurrence of lipodystrophy (LD).
To evaluate LD prevalence and subtypes in HIV treatment-multiexperienced patients, and to determine the correlations between adipocytokines and LD subtypes.
Cross-sectional study in a Romanian tertiary care hospital, between 2008 and 2010, in HIV-positive patients, undergoing cART for ≥6 months. LD diagnosis, based on clinical and anthropometric data, was classified into lipoatrophy (LA), lipohypertrophy (LH) and mixed fat redistribution (MFR). Blood samples were collected for leptin, adiponectin and resistin assessments.
We included 100 patients, 44 % with LD, among which LA had 63 %. LA patients had sex ratio, median age, treatment duration and median number of ARV regimens of 1, 20, 93 and 3.5 compared to non-LD patients: 1.65, 31, 44 and 1. LH and MFR patients were older and had higher total and LDL cholesterol versus non-LD patients. For both overall group and female group, LA was associated in univariate and multivariate analysis with increased resistin (p = 0.02 and 0.04) and number of ARV regimens (p < 0.001). Determination coefficient (Nagelkerke R (2)) of increased resistin and the number of ARV combinations in the presence of LA was 33 % in overall group and 47 % in female patients.
In our young HIV-positive population, LD had high prevalence with predominance of LA subtype. LA was associated with high resistin levels and greater number of ARV regimens in overall group and female subgroup. Resistin could be used as a marker of peripheral adipose tissue loss and might be used as a target for new anti-LD therapeutic strategies.
脂肪细胞因子生成受损是脂肪营养不良（LD）发生的一个主要因素。
评估接受多种HIV治疗的患者中LD的患病率和亚型，并确定脂肪细胞因子与LD亚型之间的相关性。
2008年至2010年在罗马尼亚一家三级护理医院对接受抗逆转录病毒治疗（cART）≥6个月的HIV阳性患者进行横断面研究。根据临床和人体测量数据进行LD诊断，分为脂肪萎缩（LA）、脂肪增生（LH）和混合性脂肪重新分布（MFR）。采集血样进行瘦素、脂联素和抵抗素评估。
我们纳入了100例患者，44%患有LD，其中LA占63%。与非LD患者相比，LA患者的性别比、中位年龄、治疗时间和抗逆转录病毒治疗方案的中位数量分别为1、20、93和3.5，而非LD患者分别为1.65、31、44和1。LH和MFR患者比非LD患者年龄更大，总胆固醇和低密度脂蛋白胆固醇更高。对于总体组和女性组，在单变量和多变量分析中，LA均与抵抗素升高（p = 0.02和0.04）及抗逆转录病毒治疗方案数量增加（p < 0.001）相关。在总体组中，存在LA时抵抗素升高和抗逆转录病毒治疗组合数量增加的决定系数（Nagelkerke R(2)）为33%，在女性患者中为47%。
在我们年轻的HIV阳性人群中，LD患病率较高，以LA亚型为主。在总体组和女性亚组中，LA与高抵抗素水平及更多的抗逆转录病毒治疗方案相关。抵抗素可作为外周脂肪组织丢失的标志物，并可能用作新的抗LD治疗策略的靶点。
