title: Human immunodeficiency virus type 1-related lipoatrophy and lipohypertrophy are associated with serum concentrations of leptin.
abstract: 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 >or=6 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.
authors.affiliation: Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: G Sonia
authors.initials: GS
authors.lastname: Nagy
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.forename: Lizabeth D
authors.initials: LD
authors.lastname: Martin
authors.forename: Anchalee
authors.initials: A
authors.lastname: Avihingsanon
authors.forename: Alina
authors.initials: A
authors.lastname: Gavrila
authors.forename: William C
authors.initials: WC
authors.lastname: Hsu
authors.forename: Adolf W
authors.initials: AW
authors.lastname: Karchmer
authors.forename: Christos S
authors.initials: CS
authors.lastname: Mantzoros
mesh_terms: D000328:Adult; D001284:Atrophy / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D006984:Hypertrophy / Q000209:etiology; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
chemical_list: D020738:Leptin