title: Non-traditional adipokines in pediatric HIV-related lipodystrophy: a-FABP as a biomarker of central fat accumulation.
abstract: BACKGROUND
  Lipodystrophy characterized by adipose tissue redistribution and lipid and glucose metabolism abnormalities, is common among HIV-infected adults and children on highly-active-antiretroviral-therapy (HAART). In a previous study of HIV-infected children, we did not detect insulin resistance, despite a high percentage of body fat redistribution abnormalities.
  
  
  OBJECTIVE
  To investigate the non-traditional adipokines Retinol-binding-Protein-4 (RBP4), neutrophil-gelatinase-associated-lipocalin (NGAL), a-Fatty-Acid-Binding-Protein (a-FABP) and YKL-40 in HIV-infected children on highly-active-antiretroviral-therapy and evaluate their possible association to lipodystrophic changes or insulin resistance.
  
  
  METHODS
  Seventeen vertically HIV-infected children (mean age: 12.5 years, mean duration of HAART: 5.2 years) and 20 age- and BMI-matched controls were recruited. The HIV-children were re-evaluated after 12 months. RBP4, NGAL, a-FABP and YKL-40 were assessed at study entry and 12 months later and were correlated to body fat content and insulin resistance.
  
  
  RESULTS
  RBP4 values were similar at study entry and 12 months later in HIV-children and controls and showed no correlation to body fat or insulin resistance. NGAL was lower in HIV children at study entry but normalized after 12 months with no positive correlation to insulin resistance. a-FABP was positively correlated to body fat content, especially to trunk fat, both at initial evaluation and at follow-up in HIV children and, after prolonged highly-active-antiretroviral-therapy, it was also positively correlated to insulin resistance.
  
  
  CONCLUSIONS
  This study is the first one to demonstrate that a-FABP could be a useful marker in unraveling central fat accumulation in HIV-infected children on highly-active-antiretroviral-therapy. Large prospective studies are needed to confirm these results.
authors.affiliation: First Department of Pediatrics, University of Athens, 'Aghia Sophia' Children's Hospital , Athens.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Theodoridou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Margeli
authors.forename: Vana
authors.initials: V
authors.lastname: Spoulou
authors.forename: Irini
authors.initials: I
authors.lastname: Bathrellou
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Skevaki
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papassotiriou
authors.forename: Christina
authors.initials: C
authors.lastname: Kanaka-Gantenbein
mesh_terms: D050153:Abdominal Fat / Q000187:drug effects / Q000473:pathology*; D000209:Acute-Phase Proteins; D054392:Adipokines / Q000097:blood; D050154:Adiposity / Q000187:drug effects; D000293:Adolescent; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D050218:Body Fat Distribution; D002648:Child; D002675:Child, Preschool; D000071451:Chitinase-3-Like Protein 1; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D037102:Lectins / Q000097:blood; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008060:Lipodystrophy / Q000097:blood* / Q000139:chemically induced; D008137:Longitudinal Studies; D008297:Male; D011518:Proto-Oncogene Proteins / Q000097:blood; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism; D012306:Risk
chemical_list: D000209:Acute-Phase Proteins; D054392:Adipokines; D019380:Anti-HIV Agents; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins; C489506:LCN2 protein, human; D037102:Lectins; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma