Lipodystrophy syndrome in HIV treatment-multiexperienced patients: implication of resistin

• Published in: Journal of endocrinological investigation Vol. 37; no. 6; pp. 533 - 539
• Main Authors: Arama, V., Munteanu, D. I., Streinu Cercel, A., Ion, D. A., Mihailescu, R., Tiliscan, C., Tudor, A. M., Arama, S. S.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-06-2014
• Subjects: Adiponectin - blood; Adult; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Cross-Sectional Studies; Endocrinology; Female; HIV Infections - blood; HIV Infections - drug therapy; HIV-Associated Lipodystrophy Syndrome - blood; HIV-Associated Lipodystrophy Syndrome - epidemiology; Humans; Leptin - blood; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Article; Prevalence; Resistin - blood; Young Adult; Lipodystrophy; Metabolic changes; Lipoatrophy; Antiretroviral therapy; Resistin
• ISSN: 1720-8386; 1720-8386
• DOI: 10.1007/s40618-014-0057-x

Background
Impaired production of adipocytokines is a major factor incriminated in the occurrence of lipodystrophy (LD).
Objective
To evaluate LD prevalence and subtypes in HIV treatment-multiexperienced patients, and to determine the correlations between adipocytokines and LD subtypes.
Methods
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.
Results
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.
Conclusions
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.