[41] INCRETIN HORMONE RESPONSE TO ORAL GLUCOSE IS PRESERVED IN LIPODYSTROPHIC HIV PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE

5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV

8–11 July 2003, Le Meridien Montparnasse, Paris, France

INCRETIN HORMONE RESPONSE TO ORAL GLUCOSE IS PRESERVED IN LIPODYSTROPHIC HIV PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE

O Andersen¹, SB Haugaard^1,2, JJ Holst³, J Iversen¹, UB Andersen⁴, JO Nielsen¹ and S Madsbad²
¹of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark; ²Department of Endocrinology and Internal Medicine, Hvidovre University Hospital, Copenhagen, Denmark; ³Department of Medical Physiology, Panum Institute, University of Copenhagen, Copenhagen, Denmark; and ⁴Department of Clinical Physiology, Hvidovre University Hospital, Denmark

Antiviral Therapy 2003; 8:L32 (abstract 41)

OBJECTIVES: Patients with HIV-associated lipodystrophy syndrome (LIPO) exhibit insulin resistance and, more often, impaired glucose tolerance (IGT) compared with HIV patients without lipodystrophy (NONLIPO). The incretin hormones glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are major regulators of glucose tolerance by stimulating insulin secretion. It is not known whether reduced incretin responses contribute to IGT amongst LIPO.

METHODS: Six LIPO with normal glucose tolerance (NGT), eight LIPO with IGT and 12 NONLIPO with NGT (all Caucasian males) underwent a 180 min oral 75 g glucose tolerance test, including frequent measurements of plasma glucose, insulin, C-peptide, GLP-1 and GIP.

RESULTS: IGT LIPO compared with NGT NONLIPO exhibited increased area under the curve (AUC) of glucose (+24%, P=0.0002), AUC-insulin (+61%, P=0.01), AUC-C-peptide (+40%, P=0.03), AUC-GLP-1 (+37%, P=0.15) and incremental AUC-GLP-1 (+85%, P=0.04), respectively, whereas AUC-GIP did not differ between these groups (P=0.70). Between NGT LIPO and NGT NONLIPO values of GLP-1 and GIP were not significantly different.

CONCLUSIONS: GLP-1 secretion was not impaired in IGT LIPO. On the contrary, in IGT LIPO the incremental GLP-1 response was increased compared with NGT NONLIPO, perhaps reflecting a compensatory response rather than explaining the IGT.

Presenting author: O Andersen

2003-07-08
41

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