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Lipodystrophy defined by Fat Mass Ratio in HIV-infected patients is associated with a high prevalence of glucose disturbances and insulin resistance.
BMC Infect Dis 2012; 12:180BI

Abstract

INTRODUCTION

Combined antiretroviral therapy (cART) in the treatment of HIV-1 infection has been associated with complications, including lipodystrophy, hyperlipidaemia, insulin resistance (IR) and diabetes.

AIMS

To compare the prevalence of glucose homeostasis disturbances and IR in HIV patients on cART according to the presence of lipodystrophy (defined clinically and by Fat Mass Ratio) and different patterns of fat distribution and to establish their associations.

DESIGN

Cross-sectional cohort study.

METHODS

We evaluated body composition and IR and insulin sensitivity indexes in 345 HIV-infected adults.

RESULTS

Patients with clinical lipodystrophy (CL) had higher plasma glucose levels than patients without CL, without significant differences in plasma insulin levels, A1c, HOMA-IR, HOMA-B, QUICKI, or MATSUDA index. Patients with lipodystrophy defined by FMR had higher plasma glucose and insulin levels, A1c, HOMA-IR, QUICKI and MATSUDA than patients without lipodystrophy, without differences in HOMA-B. Higher insulin resistance (HOMA-IR ≥ 4) was present in patients with FMR-defined lipodystrophy. Patients with FMR-defined lipodystrophy had a higher prevalence of IFG, IGT and DM than patients without lipodystrophy. Significant associations between HOMA-IR and total, central and central/peripheral fat evaluated by CT at abdominal level were found and no association between HOMA-IR and peripheral fat. Association between HOMA-IR and total and trunk fat but no association with leg and arm fat (evaluated by DXA) was found.

CONCLUSIONS

IR and glucose disturbances were significantly increased in patients with FMR-defined lipodystrophy. FMR lipodystrophy definition seems to be a more sensitive determinant of insulin resistance and glucose disturbances than clinical definition.

Authors+Show Affiliations

Department of Endocrinology, Hospital de São João, University of Porto Medical School, Alameda Hernâni Monteiro, 4200, Porto, Portugal, Portugal. paula_freitas@sapo.ptNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22866963

Citation

Freitas, Paula, et al. "Lipodystrophy Defined By Fat Mass Ratio in HIV-infected Patients Is Associated With a High Prevalence of Glucose Disturbances and Insulin Resistance." BMC Infectious Diseases, vol. 12, 2012, p. 180.
Freitas P, Carvalho D, Santos AC, et al. Lipodystrophy defined by Fat Mass Ratio in HIV-infected patients is associated with a high prevalence of glucose disturbances and insulin resistance. BMC Infect Dis. 2012;12:180.
Freitas, P., Carvalho, D., Santos, A. C., Mesquita, J., Matos, M. J., Madureira, A. J., ... Medina, J. L. (2012). Lipodystrophy defined by Fat Mass Ratio in HIV-infected patients is associated with a high prevalence of glucose disturbances and insulin resistance. BMC Infectious Diseases, 12, p. 180. doi:10.1186/1471-2334-12-180.
Freitas P, et al. Lipodystrophy Defined By Fat Mass Ratio in HIV-infected Patients Is Associated With a High Prevalence of Glucose Disturbances and Insulin Resistance. BMC Infect Dis. 2012 Aug 6;12:180. PubMed PMID: 22866963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipodystrophy defined by Fat Mass Ratio in HIV-infected patients is associated with a high prevalence of glucose disturbances and insulin resistance. AU - Freitas,Paula, AU - Carvalho,Davide, AU - Santos,Ana Cristina, AU - Mesquita,Joana, AU - Matos,Maria João, AU - Madureira,Antonio Jose, AU - Martinez,Esteban, AU - Sarmento,António, AU - Medina,José Luís, Y1 - 2012/08/06/ PY - 2012/02/27/received PY - 2012/07/13/accepted PY - 2012/8/8/entrez PY - 2012/8/8/pubmed PY - 2013/2/23/medline SP - 180 EP - 180 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 12 N2 - INTRODUCTION: Combined antiretroviral therapy (cART) in the treatment of HIV-1 infection has been associated with complications, including lipodystrophy, hyperlipidaemia, insulin resistance (IR) and diabetes. AIMS: To compare the prevalence of glucose homeostasis disturbances and IR in HIV patients on cART according to the presence of lipodystrophy (defined clinically and by Fat Mass Ratio) and different patterns of fat distribution and to establish their associations. DESIGN: Cross-sectional cohort study. METHODS: We evaluated body composition and IR and insulin sensitivity indexes in 345 HIV-infected adults. RESULTS: Patients with clinical lipodystrophy (CL) had higher plasma glucose levels than patients without CL, without significant differences in plasma insulin levels, A1c, HOMA-IR, HOMA-B, QUICKI, or MATSUDA index. Patients with lipodystrophy defined by FMR had higher plasma glucose and insulin levels, A1c, HOMA-IR, QUICKI and MATSUDA than patients without lipodystrophy, without differences in HOMA-B. Higher insulin resistance (HOMA-IR ≥ 4) was present in patients with FMR-defined lipodystrophy. Patients with FMR-defined lipodystrophy had a higher prevalence of IFG, IGT and DM than patients without lipodystrophy. Significant associations between HOMA-IR and total, central and central/peripheral fat evaluated by CT at abdominal level were found and no association between HOMA-IR and peripheral fat. Association between HOMA-IR and total and trunk fat but no association with leg and arm fat (evaluated by DXA) was found. CONCLUSIONS: IR and glucose disturbances were significantly increased in patients with FMR-defined lipodystrophy. FMR lipodystrophy definition seems to be a more sensitive determinant of insulin resistance and glucose disturbances than clinical definition. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/22866963/Lipodystrophy_defined_by_Fat_Mass_Ratio_in_HIV_infected_patients_is_associated_with_a_high_prevalence_of_glucose_disturbances_and_insulin_resistance_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-12-180 DB - PRIME DP - Unbound Medicine ER -