Metabolic basis of HIV-lipodystrophy syndrome.
Human immunodeficiency virus (HIV)-lipodystrophy syndrome (HLS) is characterized by hypertriglyceridemia, low high-density lipoprotein-cholesterol, lipoatrophy, and central adiposity. We investigated fasting lipid metabolism in six men with HLS and six non-HIV-infected controls. Compared with controls, HLS patients had lower fat mass (15.9 +/- 1.3 vs. 22.3 +/- 1.7 kg, P < 0.05) but higher plasma glycerol rate of appearance (R(a)), an index of total lipolysis (964.71 +/- 103.33 vs. 611.08 +/- 63.38 micromol x kg fat(-1) x h(-1), P < 0.05), R(a) palmitate, an index of net lipolysis (731.49 +/- 72.36 vs. 419.72 +/- 33.78 micromol x kg fat(-1) x h(-1), P < 0.01), R(a) free fatty acids (2,094.74 +/- 182.18 vs. 1,470.87 +/- 202.80 micromol x kg fat(-1) x h(-1), P < 0.05), and rates of intra-adipocyte (799.40 +/- 157.69 vs. 362.36 +/- 74.87 micromol x kg fat(-1) x h(-1), P < 0.01) and intrahepatic fatty acid reesterification (1,352.08 +/- 123.90 vs. 955.56 +/- 124.09 micromol x kg fat(-1) x h(-1), P < 0.05). Resting energy expenditure was increased in HLS patients (30.51 +/- 2.53 vs. 25.34 +/- 1.04 kcal x kg lean body mass(-1) x day(-1), P < 0.05), associated with increased non-plasma-derived fatty acid oxidation (139.04 +/- 24.17 vs. 47.87 +/- 18.81 micromol x kg lean body mass(-1) x min(-1), P < 0.02). The lipoatrophy observed in HIV lipodystrophy is associated with accelerated lipolysis. Increased hepatic reesterification promotes the hypertriglyceridemia observed in this syndrome.
Section of Endocrinology and Department of Medicine, Children's Nutrition Research Center and US Department of Agriculture/Agricultural Research Service, Baylor College of Medicine, Houston 77030, USA.
Rajagopal V
RV
Sekhar
Farook
F
Jahoor
A Clinton
AC
White
Henry J
HJ
Pownall
Fehmida
F
Visnegarwala
Maria C
MC
Rodriguez-Barradas
Morali
M
Sharma
Peter J
PJ
Reeds
Ashok
A
Balasubramanyam
D017667:Adipocytes / Q000378:metabolism; D000273:Adipose Tissue / Q000473:pathology; D004734:Energy Metabolism; D004951:Esterification; D005215:Fasting / Q000378:metabolism; D005227:Fatty Acids / Q000378:metabolism; D005990:Glycerol / Q000097:blood; D015658:HIV Infections / Q000150:complications*; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D050356:Lipid Metabolism; D008060:Lipodystrophy / Q000378:metabolism* / Q000473:pathology / Q000821:virology*; D008066:Lipolysis; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010084:Oxidation-Reduction; D012016:Reference Values; D013577:Syndrome
D005227:Fatty Acids; D005990:Glycerol