title: Impact of antiretroviral therapy on selected metabolic disorders - pilot study.
abstract: BACKGROUND
  Taking into consideration the aging of HIV infected individuals, changes in the metabolism aggravated by the antiretroviral therapy significantly impact their health. Mechanisms responsible for lipodystrophy, dyslipidemia and insulin resistance (IR) occurrence have not been completely understood. Only recently, the free fatty acids (FFAs) metabolic turnover has become considered to be the independent risk factor for cardiovascular complications.
  
  
  METHODS
  We designed the follow-up study in which patients were recruited before the introduction of ARV therapy and then observed up to 1 year. The impact of ARV therapy on the development of metabolic complications, inflammation markers and changes in adipokines secretion was investigated. The fasting and postprandial responses of FFAs, triglycerides (TG), glucose, insulin and glucose-dependent insulinotropic peptide (GIP) were measured. Changes in body composition were followed by impedance and a CT scan of adipose tissue volume of the abdomen and thighs.
  
  
  RESULTS
  Significant impact of ARV therapy on metabolic disturbances was reported. Not only fasting, but also postprandial levels of FFAs and TG were found to increase during the follow up.
  
  
  CONCLUSIONS
  The increased concentration of FFAs is suggested to be the triggering event in the development of hypertriglyceridemia and insulin resistance during ARV therapy. Changes in postprandial FFAs and TG during the follow up indicate the increasing risk of cardiovascular diseases. We conclude that modern ARV therapy during the period of 12 months does not induce changes in the fat distribution, although increased limb fat correlated with higher plasma leptin level, which may be the marker of increased risk of metabolic driven cardiovascular complications.
authors.affiliation: Chair of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Bociąga-Jasik
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Polus
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Góralska
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Raźny
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Dominika
authors.initials: D
authors.lastname: Siedlecka
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zapała
authors.affiliation: Department of Radiology, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Chrzan
authors.affiliation: Chair of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Garlicki
authors.affiliation: Chair of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mach
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland.
authors.forename: Aldona
authors.initials: A
authors.lastname: Dembińska-Kieć
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D001823:Body Composition / Q000187:drug effects; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008659:Metabolic Diseases / Q000209:etiology*; D010865:Pilot Projects; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
chemical_list: D044966:Anti-Retroviral Agents; D005230:Fatty Acids, Nonesterified; D014280:Triglycerides