Glucose production pathways by 2H and 13C NMR in patients with HIV-associated lipoatrophy.
Patients with HIV taking protease inhibitors were selected for the presence (five subjects) or absence (five subjects) of lipoatrophy. Following an overnight fast, subjects were given oral (2)H(2)O in divided doses (5 mL/kg body water), [U-(13)C(3)] propionate (10 mg/kg), and acetaminophen (1000 mg). Glucose (from plasma) or acetaminophen glucuronide (from urine) were converted to monoacetone glucose for (2)H NMR and (13)C NMR analysis. The fraction of plasma glucose derived from gluconeogenesis was not significantly different between groups. However, flux from glycerol into gluconeogenesis relative to glucose production was increased from 0.20 +/- 0.13 among subjects without lipoatrophy to 0.42 +/- 0.12 (P < 0.05) among subjects with lipoatrophy, and the TCA cycle contribution was reduced. Lipoatrophy was associated with an abnormal profile of glucose production as assessed by (13)C and (2)H NMR of plasma and urine.
Weis
Brian C
BC
The Mary Nell and Ralph B. Rogers Magnetic Resonance Center, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75235-9085, USA.
Margolis
David
D
Burgess
Shawn C
SC
Merritt
Matthew E
ME
Wise
Holly
H
Sherry
A Dean
AD
Malloy
Craig R
CR
D000082:Acetaminophen / Q000031:analogs & derivatives* / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D002247:Carbon Isotopes; D002952:Citric Acid Cycle; D003903:Deuterium; D005215:Fasting; D005260:Female; D005943:Gluconeogenesis; D005947:Glucose / Q000096:biosynthesis*; D005990:Glycerol / Q000378:metabolism; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D039682:HIV-Associated Lipodystrophy Syndrome / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry; D011422:Propionates; D014867:Water
D001786:Blood Glucose; D002247:Carbon Isotopes; D017320:HIV Protease Inhibitors; D011422:Propionates; D014867:Water; D000082:Acetaminophen; C037386:acetaminophen glucuronide; D003903:Deuterium; D005947:Glucose; C029658:propionic acid; D005990:Glycerol