suPAR associates to glucose metabolic aberration during glucose stimulation in HIV-infected patients on HAART.
OBJECTIVE
We have recently shown that the level of soluble urokinase plasminogen activator receptor (suPAR), which is associated with the immune status of HIV-infected patients undergoing highly active antiretroviral therapy (HAART), correlates with the insulin action of such patients. Here we extend these findings by investigating the association of suPAR to glucose metabolic insufficiency during an oral glucose challenge (OGTT).


METHODS
In 16 HIV-infected patients with lipodystrophy and 15 HIV-infected patients without lipodystrophy, glucose tolerance, insulin sensitivity (ISI(composite)), prehepatic insulin secretion, proinsulin level and suppression of free fatty acids (FFA) were determined during an OGTT. Stability of suPAR was tested in 6 HIV-infected patients during a 3h OGTT.


RESULTS
Lipodystrophy was associated with a 70% increase in plasma suPAR (P<0.05). During the OGTT, plasma suPAR correlated inversely with ISI(composite) and positively with 2h plasma glucose, fasting insulin secretion, fasting intact proinsulin and FFA level during the OGTT (all P<0.05). In multiple regression analyses, in which anthropometric measures (BMI, limbadiposity and fat mass), immune markers (CD4, HIV-RNA, duration of HIV infection), and dyslipidemia (plasma total cholesterol, triglyceride and free fatty acid level during the OGTT) were included, suPAR remained a significant marker of glucose tolerance and insulin sensitivity. Plasma suPAR exhibited a small CV (11%) during the 3h OGTT.


CONCLUSIONS
suPAR associated to important glucose metabolic aberrations in HIV-infected patients on HAART. Moreover, suPAR was stable after a glucose challenge. Future research is required to confirm these findings and explore the potential of suPAR as marker of dysmetabolism in HIV-infected patients.
Andersen
Ove
O
Department of Infectious Diseases, Copenhagen University, Hvidovre Hospital, DK 2650 Hvidovre, Copenhagen, Denmark. oandersen@dadlnet.dk
Eugen-Olsen
Jesper
J
Kofoed
Kristian
K
Iversen
Johan
J
Haugaard
Steen B
SB
D000886:Anthropometry; D023241:Antiretroviral Therapy, Highly Active; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D005951:Glucose Tolerance Test; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood / Q000188:drug therapy; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D011384:Proinsulin / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000097:blood*; D055293:Receptors, Urokinase Plasminogen Activator
D007328:Insulin; C524898:PLAUR protein, human; D011956:Receptors, Cell Surface; D055293:Receptors, Urokinase Plasminogen Activator; D011384:Proinsulin; D005947:Glucose