Do lipoatrophic HIV1-infected patients present the same metabolic abnormalities as those with abdominal fat accumulation?
Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB757)
Thoni G, Reynes J, Mercier J, Varray A, Baillat V, Fabre J, Fedou C G. Thoni, Sport, Performance, Health, Faculte des sciences du sport, 700 av du pic st loup, 34090 Montpellier, France, France, Tel.: +33 4 67 41 57 30, Fax: +33 4 67 41 57 50, E-mail: gilles.thoni@sc.univ-montp1.fr
We investigated whether the two main dysmorphic changes called "lipodystrophy" could induce distinct metabolic exercise dysregulations. We studied 36 lipodystrophic patients (36.3 é 1.4 years) divided into two different groups : one group of visceral fat hypertrophic patients (H) 'visceral adipose tissue (VAT)/total adipose tissue (TAT)>0.4; n = 15' and group of peripheral lipoatrophic patients (L) `VAT/TAT>0.4; n = 11', matched on age, BMI, sex ratio, immuno-virologic state and maximal theoretical cardio-respiratory fitness. Fasting blood insulin, glucose and lipids were measured. Cardio-respiratory and venous lactate values were followed during a maximal incremental exercise test on cycloergometer. The metabolic values were compared by using unpaired-t-test analysis. Results are mean é SEM. H exhibited significant higher values of total cholesterol, triglycerides, blood insulin and Insulin resistance index `homeostasis model assessment (HOMA) = 3.2 é 0.6 vs 1.5 é 0.2; p>0.001'. Resting lactatemia was higher in H (2.4 é 0.2 vs 1.8 é 0.1mmol.l-l; p > 0.05) but this difference disappeared during exercise. Maximal oxygen uptake (VO2max) and maximal power were reduced in both groups when compared with theoretical values, but significantly more in L group (p > 0.1; p > 0.01; respectively). A comparable result was observed concerning ventilatory threshold (34 é 1% vs 44 é 3% of theoretical VO2max, p>0.05) pointing out a more severe decrease in peripheral oxidative capacities in this group. Lipodystrophic subjects exhibited exercise limitation (decreased cardiorespiratory fitness) already known in global HIV-infected population. Furthermore, patients with truncal fat accumulation exhibited more resting metabolic dysregulations (higher cholesterol, triglycerides, insulin-resistance and blood lactate values). Surprisingly, lipoatrophic patients had a more impaired aerobic capacity. These results show that two clinical signs of lipodystrophy lead to specific metabolic abnormalities
Keywords: AEGIS, Obesity, Fats, Lipodystrophy, Adipose Tissue, Lipids, Insulin, Abdomen, Insulin Resistance, Triglycerides, HIV Infections, Exercise, Fasting, Body Mass Index, Case-Control Studies, Human, Metabolism, abnormalities 000709
ThOrB757
