The effect of tenofovir disoproxil fumarate on whole-body insulin sensitivity, lipids and adipokines in healthy volunteers.
BACKGROUND
Certain antiretrovirals are known to affect lipid and glucose homeostasis. The aim of this study was to assess the effect on insulin sensitivity (determined by peripheral glucose uptake using a hyperinsulinaemic euglycaemic clamp) of tenofovir disoproxil fumarate (TDF) administration compared with placebo for 2 weeks in HIV-1-seronegative healthy male volunteers. Changes in lipids, adiponectin, leptin, plasminogen activator inhibitor 1 (PAI-1) and the adhesion molecules E-selectin and P-selectin were also assessed.


METHODS
This was a single-centre, randomized, double-blinded, placebo-controlled study that used a two-sequence, two-period cross-over design. A total of 19 HIV-negative males were recruited to the study and randomized 1:1 to receive either 2 weeks of TDF (300 mg once daily) followed by 2 weeks of placebo or placebo initially followed by tenofovir. Clamps were performed at baseline, after 2 weeks and after 4 weeks.


RESULTS
All three clamps were completed by 16 participants. During the euglycaemic clamp, there were no significant changes in insulin sensitivity after 2 weeks of TDF administration compared with placebo or baseline. There was a significant reduction in the mean total cholesterol (9.4%) and low-density lipoprotein (LDL; 8.1%) cholesterol following 2 weeks of TDF compared with placebo. Levels of adiponectin, leptin, PAI-1, P-selectin and E-selectin were not significantly altered.


CONCLUSIONS
TDF use for 2 weeks does not affect insulin sensitivity, as assessed by the hyperinsulinaemic euglycaemic clamp in HIV-negative male volunteers. TDF use resulted in modest, but statistically significant, reductions in total and LDL cholesterol.
Randell
Paul A
PA
Chelsea and Westminster Hospital, London, UK. paul.randell@chelwest.nhs.uk
Jackson
Akil G
AG
Zhong
Lijie
L
Yale
Kitty
K
Moyle
Graeme J
GJ
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D054392:Adipokines / Q000378:metabolism*; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000494:pharmacology; D002784:Cholesterol / Q000378:metabolism; D008078:Cholesterol, LDL / Q000187:drug effects / Q000378:metabolism; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D015309:Glucose Clamp Technique; D018023:HIV Seronegativity / Q000187:drug effects*; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage* / Q000494:pharmacology; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D000068698:Tenofovir; D016896:Treatment Outcome; D055815:Young Adult
D054392:Adipokines; D019380:Anti-HIV Agents; D008078:Cholesterol, LDL; D007328:Insulin; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D002784:Cholesterol; D000068698:Tenofovir; D000225:Adenine