Hypoadiponectinemia, dyslipidemia, and impaired growth in children with HIV-associated facial lipoatrophy.
OBJECTIVE
To compare growth, lipids and adipocytokines in HIV-positive children with and without lipoatrophy.


METHODS
Eleven HIV-positive children with facial lipoatrophy, and 22 age- and sex-matched HIV-positive controls without signs of fat abnormality.


METHODS
Clinical data including height, physical examination findings, medications, markers of viral control, cholesterol, and triglycerides were retrieved from the medical charts. Serum samples were analyzed for adiponectin, inflammatory markers, and high density lipoprotein cholesterol (HDL).


RESULTS
Lipoatrophy was associated with higher triglycerides (330 vs 133 mg/dl, p = 0.0003), lower HDL (33 vs 48 mg/dl, p = 0.02), and a greater frequency of hypercholesterolemia (total cholesterol > 200 mg/dl; 64% vs 23%, p < 0.03). Adiponectin was 53% lower in patients with lipodystrophy (6.9 microg/ml vs 14.8 microg/ml, p = 0.005), however there was no difference in the inflammatory markers soluble TNFa receptor 2 or interleukin 6. Strikingly, despite similar BMI z-scores and virological control, lipoatrophic patients were shorter by 1 standard deviation score (p = 0.03).


CONCLUSIONS
The presence of facial lipoatrophy in a child with HIV infection is a marker for significant metabolic derangements including dyslipidemia and hypoadiponectinemia, and suggests the need for careful growth evaluation.
Kim
Roy J
RJ
Division of Endocrinology, Department of Pediatrics, Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia 19104, USA. kimr@email.chop.edu
Carlow
Dean C
DC
Rutstein
Jessica H
JH
Rutstein
Richard M
RM
D052242:Adiponectin / Q000097:blood* / Q000378:metabolism; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D050171:Dyslipidemias / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008297:Male
D052242:Adiponectin; D015415:Biomarkers; D008076:Cholesterol, HDL