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.
Sekhar
Rajagopal V
RV
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.
Jahoor
Farook
F
White
A Clinton
AC
Pownall
Henry J
HJ
Visnegarwala
Fehmida
F
Rodriguez-Barradas
Maria C
MC
Sharma
Morali
M
Reeds
Peter J
PJ
Balasubramanyam
Ashok
A
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