Is resistin a link between highly active antiretroviral therapy and fat redistribution in HIV-infected children?
OBJECTIVE
To assess the features of fat redistribution, detected by clinical and ultrasound (US) methods, and the presence of metabolic disorders in HIV-infected children undergoing antiretroviral therapy. To evaluate if serum levels of resistin, a hormone produced only by visceral adipose tissue, are a marker of fat redistribution in these patients.


METHODS
Forty-five consecutive symptomatic HIV-infected children were considered for inclusion in the study. Patients were enrolled if treated for at least 6 months with antiretroviral therapy with or without protease inhibitor (PI) and if compliant to the study protocol. Patients were evaluated for: anthropometric measures, fat redistribution by clinical and US methods, serum lipids, parameters of insulin resistance by homeostasis model assessment for insulin resistance, serum resistin levels by an enzyme-linked immunosorbent assay.


RESULTS
Eighteen children fulfilled the inclusion criteria and were enrolled in the study. Twelve (66%) children had clinical and/or US evidence of fat redistribution; 9 (75%) of them were on PI therapy; only 3 of 6 children without fat redistribution were on PI therapy (p<0.05). Serum lipids and insulin resistance parameters did not differ between children with or without fat redistribution. There was a highly significant linear correlation between visceral fat detected by US and circulating resistin levels (r=0.87; p<0.0001).


CONCLUSIONS
Fat redistribution occurred in most HIV-infected children undergoing PI therapy. Because serum resistin levels reflect the amount of visceral fat, they could be considered a sensitive marker of fat redistribution in HIV-infected children.
Spagnuolo
M I
MI
Department of Pediatrics, Federico II University, 80131 Naples, Italy. mispagnu@unina.it
Bruzzese
E
E
Vallone
G F
GF
Fasano
N
N
De Marco
G
G
Officioso
A
A
Valerio
G
G
Volpicelli
M
M
Iorio
R
R
Franzese
A
A
Guarino
A
A
D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000187:drug effects* / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000818:Animals; D000886:Anthropometry; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D050218:Body Fat Distribution; D002648:Child; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced; D052243:Resistin / Q000097:blood*
D017320:HIV Protease Inhibitors; D052243:Resistin
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