Total energy expenditure and carbohydrate oxidation are increased in the human immunodeficiency virus lipodystrophy syndrome.
To determine whether total energy expenditure (TEE) is increased in the human immunodeficiency virus (HIV) lipodystrophy syndrome, we compared energy expenditure (EE) and substrate oxidation rates in 12 HIV-infected men with lipodystrophy, 7 HIV-infected men without lipodystrophy, and 14 healthy controls. TEE and nutrient oxidation rates were assessed by whole-room indirect calorimetry. Resting energy expenditure (REE) was measured by indirect calorimetry using the open-circuit technique. Body composition was assessed by dual-energy x-ray absorptiometry (DEXA). Insulin sensitivity was measured using the insulin-modified frequently sampled intravenous glucose tolerance test. TEE adjusted for lean body mass (LBM) was significantly higher in the HIV-infected group with lipodystrophy compared to HIV-infected patients without lipodystrophy (2,873.3 +/- 69 v 2,573.9 +/- 92 kcal/d, P =.02) and compared to healthy controls (2,873.3 +/- 69 v 2,404.0 +/- 64 kcal/d, P <.001). REE and sleeping metabolic rate (SMR) adjusted for LBM were also significantly higher in the HIV-infected group with lipodystrophy compared to both HIV-infected and healthy controls. Carbohydrate oxidation rates adjusted for LBM were higher in men with HIV lipodystrophy as compared to healthy controls (362.5 +/- 23 v 250.0 +/- 22 g/d, P = <.01) and tended to be higher as compared to HIV-infected controls (362.5 +/- 23.6 v 297.3 +/- 31 g/d, P =.1). In conclusion, TEE and carbohydrate oxidation are increased in the HIV lipodystrophy syndrome. The increase in TEE appears to be due to increases in REE. The pathogenesis of elevated EE in HIV lipodystrophy and other forms of lipodystrophy remains to be determined.
Kosmiski
Lisa A
LA
Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
Kuritzkes
Daniel R
DR
Sharp
Teresa A
TA
Hamilton
Jere T
JT
Lichtenstein
Kenneth A
KA
Mosca
Cecilia L
CL
Grunwald
Gary K
GK
Eckel
Robert H
RH
Hill
James O
JO
D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D018791:CD4 Lymphocyte Count; D002153:Calorimetry, Indirect; D004032:Diet; D004040:Dietary Carbohydrates / Q000378:metabolism*; D004734:Energy Metabolism / Q000502:physiology*; D005951:Glucose Tolerance Test; D039682:HIV-Associated Lipodystrophy Syndrome / Q000378:metabolism*; D006801:Humans; D007700:Kinetics; D008297:Male; D010084:Oxidation-Reduction; D012890:Sleep / Q000502:physiology
D004040:Dietary Carbohydrates