Racial differences in changes of metabolic parameters and body composition in antiretroviral therapy-naive persons initiating antiretroviral therapy.
OBJECTIVE
To assess by race/ethnicity long-term changes in metabolic parameters and body composition among treatment-naive persons initiating antiretroviral therapy (ART).


METHODS
We compared changes in 398 participants (African American n = 243, Latino n = 43, white n = 112) initiating ART. At baseline, 1-month (metabolic parameters only) and 4-month follow-up intervals (anthropometric measurements) were performed and fasting metabolic parameters measured. Rates of change over time and overall mean changes from baseline were compared.


RESULTS
Latinos had the greatest increase in glucose and insulin resistance and greatest loss of mid-arm and mid-thigh subcutaneous tissue areas. On average, mid-arm and mid-thigh nonsubcutaneous tissue areas increased in all races. Waist subcutaneous tissue area decreased only for Latinos. Visceral tissue area increased the most for Latinos and whites. For all groups, the initial increase in high-density lipoprotein cholesterol was sustained. The initial increase in low-density lipoprotein cholesterol was followed by a gradual decline in all groups. Triglycerides increased for all groups; the increase being the least for African Americans.


CONCLUSIONS
In this prospective long-term evaluation, changes in metabolic parameters and body composition varied across race groups. Latinos experienced the most unfavorable changes. Such changes should be monitored over time as the identified differences may impact ART selection.
Gibert
Cynthia L
CL
Section of Infectious Diseases, Veterans Affairs Medical Center, Washington, DC 20422, USA. cynthia.gibert@va.gov
Shlay
Judith C
JC
Sharma
Shweta
S
Bartsch
Glenn
G
Peng
Grace
G
Grunfeld
Carl
C
D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001786:Blood Glucose; D001823:Body Composition / Q000187:drug effects*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008297:Male; D044469:Racial Groups
D044966:Anti-Retroviral Agents; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids