Regulation of Adiponectin in Human Immunodeficiency Virus-Infected Patients: Relationship to Body Composition and Metabolic Indices
Journal of Clinical Endocrinology and Metabolism
HIV-related lipodystrophy is characterized by adipose redistribution, dyslipidemia, and insulin resistance. Adiponectin is an adipose-derived peptide thought to act as a systemic regulator of glucose and lipid metabolism. We investigated adiponectin concentrations in 10 HIV-infected patients during acute HIV infection (viral load, 2.0 ؋ 10 6 ؎ 1.0 ؋ 10 6 copies/ml) and then 6 -8 months later, as well as cross-sectionally in 41 HIV-infected patients (21 with evidence of fat redistribution and 20
... without evidence of fat redistribution) in comparison with 20 age-and body mass index-matched healthy control subjects. Circulating adiponectin concentrations did not change with treatment of acute HIV infection (5.8 ؎ 0.4 vs. 5.9 ؎ 0.7 g/ml, P ؍ 0.96) but were reduced in patients with chronic HIV infection and fat redistribution (7.8 ؎ 0.9 g/ml), compared with age-and body mass index-matched HIV-infected patients without fat redistribution (12.7 ؎ 1.7 g/ml) and healthy control subjects (11.9 ؎ 1.7 g/ml, P < 0.05 vs. HIV-infected patients without fat redistribution and vs. control subjects). Adiponectin concentrations correlated with body composition [correlation coefficient (r) ؍ ؊0.47, P ؍ 0.002 vs. trunk fat:total fat; r ؍ 0.51, P < 0.001 vs. extremity fat:total fat], insulin response to glucose challenge (r ؍ ؊0.36, P ؍ 0.03), triglyceride (r ؍ ؊0.39, P ؍ 0.01), and high-density lipoprotein (r ؍ 0.37, P ؍ 0.02) among the HIV-infected patients. Adiponectin remained a significant correlate of insulin response to GTT, controlling for medication use and body composition changes in HIV-infected patients. These data suggest a strong relationship between adiponectin and body composition in HIV-infected patients. Changes in adiponectin may contribute to the metabolic dysregulation in this group of patients. (J Clin Endocrinol Metab 88: 1559 -1564, 2003) Abbreviations: AUC, Area under the curve; BMI, body mass index; CT, computed tomography; DEXA, dual-energy x-ray absorptiometry; HAART, highly active antiretroviral therapy; HDL, high-density lipoprotein; LDL, low-density lipoprotein; NRTI, nonnucleoside reverse transcriptase inhibitor; PI, protease inhibitor; SAT, sc adipose tissue; TAT, total abdominal cross-sectional area; VAT, visceral adipose tissue.