Abnormalities in plasma fatty acid composition in human immunodeficiency virus-infected children treated with protease inhibitors.
OBJECTIVE
To study plasma fatty acid composition in human immunodeficiency virus-infected children treated with protease inhibitors and its relation with other components of the metabolic syndrome observed after this therapy.


METHODS
Cross-sectional study from collected clinical database.


METHODS
17 children with HIV infection treated with protease inhibitors. Nine patients received ritonavir (20-30 mg/kg/d) and the remaining eight received nelfinavir (60-90 mg/kg/d). Duration of protease inhibitors treatment was 711+/-208 d. As controls, we used 112 matched blood samples from apparently healthy children admitted for minor surgical procedures.


METHODS
Plasma fatty acids were determined using a Hewlett Packard GC 5890 gas chromatograph.


RESULTS
Plasma levels of cholesterol and triglycerides and insulin-like growth factor 1 (IGF-1) tended to be high in protease inhibitor-treated patients. Plasma content of omega6 long-chain polyunsaturated fatty acids and, in particular, of the highly unsaturated 22ratio4omega6 and 22ratio5omega6, was significantly increased. Also, infected children had increased Delta6 and Delta4 desaturase activities and decreased Delta5 desaturase activity. Significant correlations were present between plasma IGF-1 level and plasma triglycerides, plasminogen activator inhibitor-1 activity and Delta6 desaturase activity.


CONCLUSIONS
HIV-infected, protease inhibitor-treated children exhibit a metabolic syndrome which is associated with significant changes in plasma fatty acid composition. These changes are similar to those observed in situations of insulin resistance and are linked to variations in plasma IGF-1 concentration.
Aldámiz-Echevarría
Luis
L
Division of Metabolism, Department of Paediatrics, Hospital de Cruces and Basque University School of Medicine, Baracaldo, Basque Country, Spain. kaldamiz@hcru.osakidetza.net
Pocheville
Itziar
I
Sanjurjo
Pablo
P
Elorz
Javier
J
Prieto
Jose Angel
JA
Rodríguez-Soriano
Juan
J
D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005227:Fatty Acids / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D019888:Nelfinavir / Q000627:therapeutic use*; D019438:Ritonavir / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D005227:Fatty Acids; D005231:Fatty Acids, Unsaturated; D017320:HIV Protease Inhibitors; D014280:Triglycerides; D007334:Insulin-Like Growth Factor I; D002784:Cholesterol; D019888:Nelfinavir; D019438:Ritonavir