High Molecular Weight (HMW): total adiponectin ratio is low in hiv-infected women receiving protease inhibitors.

Q2 Medicine
BMC Clinical Pathology Pub Date : 2014-12-16 eCollection Date: 2014-01-01 DOI:10.1186/1472-6890-14-46
Fierdoz Omar, Joel A Dave, Judy A King, Naomi S Levitt, Tahir S Pillay
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引用次数: 9

Abstract

Background: At the time of the study, the HIV-treatment policy in South Africa included highly active antiretroviral therapy (HAART) regimens 1 (nucleotide reverse transcriptase inhibitors (NRTIs) only), and 2 (protease inhibitors (PI) and NRTIs). HAART is associated with the lipodystrophy syndrome, insulin resistance and reduced total adiponectin (TA) levels. The high molecular weight (HMW):TA ratio is a superior marker of insulin resistance. The aim of this study was to establish whether HMW:TA ratios are low in patients on PIs and whether they correlate with insulin resistance.

Methods: This was a cross-sectional study undertaken in an antiretroviral clinic at a tertiary hospital. The participants were 66 HIV-infected females: 22 were on regimen 2 (PI group), 22 on regimen 1 (non-PI) and 22 treatment naïve (TN), matched for BMI and age. Patients with a history of diabetes or impaired glucose tolerance were excluded. Serum adiponectin multimers were analysed using the AlpcoTM Adiponectin (Multimeric) enzyme immunoassay. Waist hip ratios (WHR), glucose and insulin levels were assessed, and HOMA-IR and QUICKI calculated. Data were analysed non-parametrically and multivariate analysis was performed.

Results: TA and HMW levels were lower in the treatment groups than in the TN group. HMW:TA was lower in the PI than in the non-PI and TN groups, and in the non-PI than in the TN groups. HMW:TA correlated negatively with waist, insulin and HOMA-IR, independently of BMI and duration of therapy. HOMA-IR and QUICKI did not differ among the groups.

Conclusion: HMW:TA is significantly decreased with HAART (particularly with PIs, but also with non-PIs) and may be a more sensitive marker of insulin resistance in these patients than conventional markers or HMW and total adiponectin individually.

Abstract Image

高分子量(HMW):总脂联素比率在接受蛋白酶抑制剂的艾滋病毒感染妇女中较低。
背景:在研究期间,南非的hiv治疗政策包括高活性抗逆转录病毒治疗(HAART)方案1(仅核苷酸逆转录酶抑制剂(NRTIs))和2(蛋白酶抑制剂(PI)和NRTIs)。HAART与脂肪营养不良综合征、胰岛素抵抗和总脂联素(TA)水平降低有关。高分子量(HMW):TA比是胰岛素抵抗的优良指标。本研究的目的是确定PIs患者的HMW:TA比率是否较低,以及它们是否与胰岛素抵抗相关。方法:这是在三级医院抗逆转录病毒诊所进行的横断面研究。参与者是66名感染艾滋病毒的女性:22人接受方案2 (PI组),22人接受方案1(非PI组),22人接受naïve (TN)治疗,BMI和年龄相匹配。排除有糖尿病史或糖耐量受损的患者。采用AlpcoTM脂联素(多聚体)酶免疫分析法分析血清脂联素多聚体。评估腰臀比(WHR)、葡萄糖和胰岛素水平,并计算HOMA-IR和QUICKI。数据进行非参数分析和多变量分析。结果:治疗组TA、HMW水平均低于TN组。HMW:TA在PI组低于非PI组和TN组,非PI组低于TN组。HMW:TA与腰围、胰岛素和HOMA-IR负相关,独立于BMI和治疗时间。HOMA-IR和QUICKI在各组之间没有差异。结论:HMW:TA在HAART治疗中显著降低(尤其是接受pi治疗的患者,但非接受pi治疗的患者也是如此),可能是这些患者胰岛素抵抗的一个更敏感的标志物,而不是常规标志物或HMW和总脂联素单独。
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来源期刊
BMC Clinical Pathology
BMC Clinical Pathology Medicine-Pathology and Forensic Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Clinical Pathology is an open access journal publishing original peer-reviewed research articles in all aspects of histopathology, haematology, clinical biochemistry, and medical microbiology (including virology, parasitology, and infection control). BMC Clinical Pathology (ISSN 1472-6890) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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