Insulin resistance and adipokines serum levels in a caucasian cohort of hiv-positive patients undergoing antiretroviral therapy: a cross sectional study

BMC Endocrine Disorders

Research Article

Daniela Ion¹  Stefan Sorin Arama¹  Victoria Arama²  Adriana Hristea²  Adrian Streinu-Cercel²  Catalin Tiliscan²  Raluca Mihailescu³  Daniela Munteanu³ 

[1] Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania;Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania;

关键词: Adipokines;    Adiponectin;    Leptin;    Antiretroviral therapy;    Insulin resistance;    HIV;   

DOI  :  10.1186/1472-6823-13-4

 received in 2012-06-27, accepted in 2013-01-23,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundInsulin resistance is frequent in human immunodeficiency virus (HIV) infection and may be related to antiretroviral therapy. Cytokines secreted by adipose tissue (adipokines) are linked to insulin sensitivity. The present study is aimed to assess the prevalence of insulin resistance (IR) and its association with several adipokines, in a non-diabetic Romanian cohort of men and women with HIV-1 infection, undergoing combination antiretroviral therapy (cART).MethodsA cross-sectional study was conducted in an unselected sample of 89 HIV-1-positive, non-diabetic patients undergoing stable cART for at least 6 months. Metabolic parameters were measured, including fasting plasma insulin, and circulating adiponectin, leptin, resistin, tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) levels. Insulin resistance was estimated by measuring the Quantitative Insulin Sensitivity Check Index (QUICKI), using a cut-off value of 0.33. A linear regression model was fitted to QUICKI to test the association of IR and adipokines levels.ResultsA total of 89 patients (aged 18–65, median: 28 years) including 51 men (57.3%) and 38 women (42.7%) were included in the study. Fifty nine patients (66.3%) were diagnosed with IR based on QUICKI values lower than the cut-off point. IR prevalence was 72.5% in men and 57.6% in women. The presence of the IR was not influenced by either the time of the HIV diagnosis or by the duration of cART. Decreased adiponectin and increased serum triglycerides were associated with increased IR in men (R=0.43, p=0.007). Hyperleptinemia in women was demonstrated to be associated with the presence of IR (R=0.33, p=0.03).ConclusionsGiven the significant prevalence of the IR in our young non-diabetic cohort with HIV infection undergoing antiretroviral therapy reported in our study and the consecutive risk of diabetes and cardiovascular events, we suggest that the IR management should be a central component of HIV-infection therapeutic strategy. As adipokines play major roles in regulating glucose homeostasis with levels varying according to the sex, we suggest that further studies investigating adipokines should base their analyses on gender differences.

【 授权许可】

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© Arama et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.