title: Pioglitazone therapy for HIV/HAART-associated lipodystrophy syndrome could increase subcutaneous fat mass in non-lipoatrophic but not in lipoatrophic regions.
abstract: Highly active antiretroviral therapy (HAART) is associated with multiple metabolic disorders, including lipodystrophy, dyslipidaemia and insulin resistance. HIV/HAART-associated lipodystrophy syndrome (HALS) is characterised by subcutaneous fat wasting, central fat accumulation and increased risk of diabetes. Thiazolidinediones are considered a promising treatment for HALS, because they improve insulin sensitivity and increase subcutaneous fat mass. In previous studies, pioglitazone increased overall fat mass in patients with HALS but whether fat distribution changes remains unclear. We describe a HALS patient with diabetes treated with pioglitazone. Prior to pioglitazone therapy, he had hollowed cheeks, loss of fat in the extremities and abdominal obesity. 18 months after starting pioglitazone and switching his HAART regimens, T1-weighted MRI showed obvious increases in the subcutaneous fat mass of the neck and upper trunk, but no changes in the cheeks and extremities. Pioglitazone therapy for HALS could increase subcutaneous fat mass in non-lipoatrophic but not in lipoatrophic regions.
authors.affiliation: Department of Diabetology, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Sadanori
authors.initials: S
authors.lastname: Okada
authors.affiliation: Center for Health Control, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Konishi
authors.affiliation: Department of Diabetology, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishii
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D050218:Body Fat Distribution; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D050151:Subcutaneous Fat / Q000187:drug effects*; D045162:Thiazolidinediones / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D045162:Thiazolidinediones; D000077205:Pioglitazone