Insulin and carbohydrate dysregulation.
Patients with human immunodeficiency virus receiving highly active antiretroviral therapy (HAART) may experience abnormal body composition changes as well as metabolic abnormalities, including dyslipidemia, increases in triglycerides, low high-density lipoprotein cholesterol levels, and abnormal carbohydrate metabolism, ranging from insulin resistance with and without glucose intolerance to frank diabetes. Whether the body composition changes (i.e., increased visceral adiposity and fat wasting in the peripheral tissues) are linked to abnormalities in carbohydrate metabolism is unclear. The use of HAART with and without therapy with protease inhibitors (PIs) is related to carbohydrate abnormalities and changes in body composition. Regimens that include PIs appear to have a higher incidence of insulin resistance (up to 90%) and diabetes mellitus (up to 40%). The etiology of these abnormalities is not well understood; what is known about insulin and carbohydrate dysregulation with HAART is discussed.
Gelato
Marie C
MC
Department of Medicine, University Hospital at Stony Brook, Stony Brook, New York 11794-8154, USA. Marie.Gelato@stonybrook.edu
D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D050260:Carbohydrate Metabolism; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D008659:Metabolic Diseases / Q000178:diet therapy / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D009017:Morbidity; D009026:Mortality; D009747:Nutritional Physiological Phenomena
D019380:Anti-HIV Agents; D007328:Insulin