부산대학교 도서관

BACKGROUND: The HIV-associated lipodystrophic syndrome (HIV-LDS) combines redistribution of fat mass with insulin resistance and hyperlipidemia. We have previously reported that HIV-LDS prevails in children in a comparable pattern as in adults. The metabolic activity itself of the lipodystrophic adipose tissue in HIV infection has been poorly studied. AIM AND METHODS: To assess in situ the insulin sensitivity of the lipohypertrophic subcutaneous abdominal adipose tissue using the microdialysis technique in HIV-infected children. Insulin sensitivity, assessed by the inhibition of glycerol release, was measured in the abdominal subcutaneous adipose tissue during a standard oral glucose tolerance test (OGTT) in six HIV-infected children under multi-therapy with abdominal lipohypertrophy (supra-iliac skinfold thickness > 97th percentile) (HIV/LH+), in six obese children (obese group) and in eight HIV-infected children without lipodystrophy (HIV/LH-) RESULTS: Glucose tolerance was normal in all subjects. Mean insulin areas under the curve (IAUC) were significantly higher in the obese and HIV/LH+ groups than in HIV/LH- (8769 ± 5429, 8161 ± 4552 and 3618 ± 2222 mU min l[SUP-1], respectively; P = 0.04 for the three groups comparison by the Kruskal - Wallis test), reflecting insulin resistance in the two former groups independent of a significant difference in percentage fat mass (37.2 ± 4.7, 22.8 ± 10.9 and 20.7 ± 7.1%, respectively; P = 0.006). The crude inhibition of glycerol release, expressed as the relative change in dialysate glycerol concentration between baseline and 120 min, was not statistically different between the three groups (14% in obese, -38 ± 14% in HIV/LH+ and -51 ± 17% in HIV/LH- groups; P = 0.3). The inhibition of glycerol release with respect to the circulating insulin level (expressed by IAUC) was similar in HIV/LH+ and obese groups (-6 ± 5 × 10[SUP-3]and -7 ± 5... [ABSTRACT FROM AUTHOR]