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

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Abstract

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.

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Abbreviations

cART:

Combined antiretroviral therapy

ARV:

Antiretroviral therapy

BMI:

Body mass index

ELISA:

Enzyme-linked immunosorbent assay

EASIA:

Enzyme Amplified Sensitivity Immunoassay

HDL:

High-density lipoprotein

HIV:

Human immunodeficiency virus

IQR:

Interquartile range

LA:

Lipoatrophy

LD:

Lipodystrophy

LDL:

Low-density lipoprotein

LH:

Lipohipertrophy

MFR:

Mixed fat redistribution

SPSS:

Statistical Package for the Social Sciences

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Acknowledgments

The authors thank all patients that agreed to participate in this study and all the study team for their contribution to the research, as well as all the medical staff involved in this study, especially: Ioana Diana Olaru, Cristina Loredana Benea, Anca Streinu Cercel, Mihaela Radulescu for their implication in recruiting and in the follow-up of the patients, and Viorica Leoveanu (deceased) for performing the assessments for the adipocytokines. The study was funded by the National Authority for Scientific Research (Grant No. 62077/2008, 2008–2011). Coordinating center: Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania. Project Manager: Prof. Adrian Streinu Cercel. Scientific coordinator: Assoc. Prof. Victoria Arama.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. National Institute of Infectious Diseases, No 1Grozovici Street, 021105, Bucharest, Romania

    V. Arama, D. I. Munteanu, A. Streinu Cercel, R. Mihailescu, C. Tiliscan & A. M. Tudor

  2. Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    V. Arama, A. Streinu Cercel, D. A. Ion, C. Tiliscan, A. M. Tudor & S. S. Arama

Authors
  1. V. Arama
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  2. D. I. Munteanu
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  3. A. Streinu Cercel
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  4. D. A. Ion
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  5. R. Mihailescu
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  6. C. Tiliscan
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  7. A. M. Tudor
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  8. S. S. Arama
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Corresponding author

Correspondence to D. I. Munteanu.

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Arama, V., Munteanu, D.I., Streinu Cercel, A. et al. Lipodystrophy syndrome in HIV treatment-multiexperienced patients: implication of resistin. J Endocrinol Invest 37, 533–539 (2014). https://doi.org/10.1007/s40618-014-0057-x

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  • DOI: https://doi.org/10.1007/s40618-014-0057-x

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