期刊
CLINICAL INFECTIOUS DISEASES
卷 36, 期 6, 页码 795-802出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/367859
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资金
- NCRR NIH HHS [M01-RR01032] Funding Source: Medline
- NHLBI NIH HHS [K30 HL04095] Funding Source: Medline
- PHS HHS [58785 R01] Funding Source: Medline
The relationship between the adipocyte-derived hormone leptin, insulin resistance, and fat redistribution in patients with human immunodeficiency virus (HIV) infection has not been established. We classified a cohort of HIV type 1 (HIV-1)-infected patients with greater than or equal to6 months of antiretroviral exposure as having no lipodystrophy (51 patients [43% of the cohort]), lipoatrophy (23 patients [19% of the cohort]), mixed lipodystrophy (29 patients [24% of the cohort]), or lipohypertrophy (17 patients [14% of the cohort]), on the basis of physical examination, anthropometric measurements, and the findings of dual-emission x-ray absorptiometry and computed tomography. Measurements of insulin resistance were higher for patients with each category of lipodystrophy, compared with those observed for patients with no lipodystrophy (P<.001). Mean leptin levels (+/- standard deviation) were lowest in patients with lipoatrophy (1.76 +/- 1.20 ng/mL), highest in patients with lipohypertrophy (9.10 +/- 6.86 ng/mL), and significantly different from those in patients without lipodystrophy (3.14 +/- 2.30 ng/mL; both P < .01). In this cohort of antiretroviral-experienced HIV-infected patients, a low serum level of leptin was independently associated with insulin resistance in patients with lipoatrophy, after controlling for total and regional body fat.
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