title: Adipokines, hormones related to body composition, and insulin resistance in HIV fat redistribution syndrome.
abstract: BACKGROUND
  Lipodystrophies are characterized by adipose tissue redistribution, insulin resistance (IR) and metabolic complications. Adipokines and hormones related to body composition may play an important role linking these alterations. Our aim was to evaluate adipocyte-derived hormones (adiponectin, leptin, resistin, TNF-α, PAI-1) and ghrelin plasma levels and their relationship with IR in HIV-infected patients according to the presence of lipodystrophy and fat redistribution.
  
  
  METHODS
  Anthropometric and metabolic parameters, HOMA-IR, body composition by DXA and CT, and adipokines were evaluated in 217 HIV-infected patients on cART and 74 controls. Fat mass ratio defined lipodystrophy (L-FMR) was defined as the ratio of the percentage of the trunk fat mass to the percentage of the lower limb fat mass by DXA. Patient's fat redistribution was classified into 4 different groups according the presence or absence of either clinical lipoatrophy or abdominal prominence: no lipodystrophy, isolated central fat accumulation (ICFA), isolated lipoatrophy and mixed forms (MXF). The associations between adipokines levels and anthropometric, metabolic and body composition were estimated by Spearman correlation.
  
  
  RESULTS
  Leptin levels were lower in patients with FMR-L and isolated lipoatrophy, and higher in those with ICFA and MXF. Positive correlations were found between leptin and body fat (total, trunk, leg, arm fat evaluated by DXA, and total, visceral (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT ratio evaluated by CT) regardless of FMR-L, and with HOMA-IR only in patients with FMR-L. Adiponectin correlated negatively with VAT, and its mean levels were lower in patients with ICFA and higher in those with no lipodystrophy. Resistin was not correlated with adipose tissue but positively correlated with HOMA-IR in FMR-L patients. PAI-1 levels were higher in MXF-patients and their levels were positively correlated with VAT in those with FMR-L. Ghrelin was higher in HIV-infected patients than controls despite BMI-matching.
  
  
  CONCLUSIONS
  The overall body fat reduction in HIV lipoatrophy was associated with low leptin plasma levels, and visceral fat accumulation was mainly associated with decreased plasma levels of adiponectin.
authors: Endocrinology Department, Hospital de São João and University of Porto Medical School, Alameda Hernâni Monteiro, 4200 Porto, Portugal. paula_freitas@sapo.pt.
authors: Paula
authors: P
authors: Freitas
authors: Davide
authors: D
authors: Carvalho
authors: Ana Cristina
authors: AC
authors: Santos
authors: António José
authors: AJ
authors: Madureira
authors: Esteban
authors: E
authors: Martinez
authors: Jorge
authors: J
authors: Pereira
authors: António
authors: A
authors: Sarmento
authors: José Luís
authors: JL
authors: Medina
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: D054392:Adipokines