Body Fat Assessment and Adipocytokine Levels in the Lipodystrophy Syndrome in HIV-infected Patients

DSpace/Manakin Repository

Body Fat Assessment and Adipocytokine Levels in the Lipodystrophy Syndrome in HIV-infected Patients

Show simple item record


dc.contributor.advisor Garg, Abhimanyu en
dc.creator Dinges, Warren L. en
dc.date.accessioned 2010-07-12T18:21:10Z en
dc.date.available 2010-07-12T18:21:10Z en
dc.date.issued 2003-06-30 12:58:00 PM en
dc.identifier.other 60129031 en
dc.identifier.uri http://hdl.handle.net/2152.5/522 en
dc.description.abstract The lipodystrophy syndrome in HIV-infected patients (LDHIV) is characterized by body morphologic and metabolic changes. This case-control study compared 16 male, HIV-infected, severely lipodystrophic patients on protease inhibitor (PI) therapy to 14 HIV-infected, non-lipodystrophic men not on PI-inclusive AART. Body fat distribution was assessed using anthropometry, whole-body MRI, and DEXA analysis. Adipocytokines were compared using fasting plasma adiponectin, leptin, and insulin levels. LDHIV patients compared to control subjects had lower peripheral fat with gluteal, suprailiac and triceps skinfolds (all p<0.01, with MRI thigh subcutaneous fat (ThSCF)(mean%񓄬 LDHIV 12񵠶s. Controls 22񱲠p=0.01) and with DEXA leg fat (%, 12񵠶s. 22񹬠p=0.0006). Dorsocervical fat (DCF) accumulation was significantly greater in LDHIV subjects by MRI depth (mm, 47񲴠vs. 19񷬠p=0.0009) and DEXA head fat (%, 18񳠶s. 16񱬠p=0.01), but not significantly by subscapular skinfold p=0.30. In LDHIV patients, abdominal fat was greater by waist circumference (cm, 98񵠶s. 86񹠰=0.0008), nearly significantly greater by MRI Intra-abdominal fat (cm2, 218񹰠vs.157񷰠p=0.057), and greater by DEXA Trunk percent total fat (%TF, 65񷠶s. 53񸠰=0.0005). In the correlation analysis of LDHIV patients, MRI IAF/ThSCF showed a strong negative relationship to DCF in all three methods r<-0.80, p<0.001, implying a novel split phenotype of either DCF or IAF accumulation. Five combined lipodystrophy parameters were derived, that well delineated the two groups (all p<0.00003). LDHIV patients compared to control subjects also had lower adiponectin levels (3.2񳮱 vs. 5.9񲮹 槯mL, p=0.01), similar leptin levels (3.5񱮵 vs. 3.0񱮶 ng/mL, p=0.49), and higher insulin levels (20񱱯19 vs. 12񶯱1 敯mL, p=0.04). There was a strong negative relationship between adiponectin and insulin levels in the LDHIV group (r=-0.73, p=0.01), but not in control subjects (p=0.33). Conversely, leptin and insulin levels in the control subjects were highly correlated (r=0.86, p<0.0001), but not in LDHIV patients (p=0.82). In conclusion, plasma adiponectin levels are low in patients with LDHIV and may be a better marker than leptin for the hyperinsulinemia of LDHIV. Also, this study has defined consistent methods to quantitatively assess the regional body fat changes and lipodystrophy severity in LDHIV using Anthropometry, DEXA, and MRI. en
dc.format.medium Electronic en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.subject Anthropometry en
dc.subject Protease Inhibitors, HIV en
dc.subject HIV-Associated Lipodystrophy Syndrome en
dc.title Body Fat Assessment and Adipocytokine Levels in the Lipodystrophy Syndrome in HIV-infected Patients en
dc.type.material Text en
dc.type.genre dissertation en
dc.format.digitalOrigin born digital en
thesis.degree.grantor Southwestern Medical School en
thesis.degree.name M.D. with Distinction en
thesis.degree.level Doctoral en
thesis.degree.discipline Research en
thesis.date.available 2003-06-30 12:58:00 PM en

Files in this item

Files Size Format View Description
dingeswarren.pdf 2.834Mb PDF View/Open Dissertation

This item appears in the following Collection(s)

Show simple item record

Search DSpace


Advanced Search

Browse

My Account