Serum leptin concentrations and fat redistribution in HIV-1-infected children on highly active antiretroviral therapy.
OBJECTIVE
HIV-related lipodystrophy is a syndrome of adipose tissue redistribution, dyslipidaemia and insulin resistance. Combination antiretroviral therapy (CART) is a key risk factor. We hypothesized that fat redistribution in HIV-infected children is related to altered endocrine function of adipose tissue, namely leptin secretion.


METHODS
Serum leptin and fat redistribution were measured in 104 HIV-infected children in a prospective observational study from 2003 to 2004. Fat redistribution was defined by clinical observation. Body fatness was estimated using body mass index and four skinfold measurements. Serum leptin was determined using an enzyme-linked immunosorbent assay (Quantikine; R&D Systems, Abingdon, UK). Linear analogue models were used to adjust the leptin concentration for body fatness.


RESULTS
There was no significant difference in serum leptin among children treated with protease inhibitors (PIs), children on non-PI CART and children not treated with CART (P>0.05). When leptin concentrations were adjusted for body fatness, there was again no difference among PI-treated, non-PI-treated and untreated children. Categorization of CART exposure as never, current or past did not change these results.


CONCLUSIONS
There is no evidence that leptin plays any role in lipodystrophy other than reflecting body fatness.
Dzwonek
A B
AB
Infectious Diseases and Microbiology Unit, University College London Institute of Child Health, and Clinical Infectious Diseases Unit, Great Ormond Street Children's Hospital NHS Trust, London, UK.
Novelli
V
V
Schwenk
A
A
D000273:Adipose Tissue / Q000378:metabolism*; D000293:Adolescent; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002648:Child; D005260:Female; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood / Q000209:etiology*; D006801:Humans; D020738:Leptin / Q000032:analysis* / Q000097:blood; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
D020738:Leptin