 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Continued
from page 13) |
|
|
|
|
Italian investigators
recently noted that people at high risk of developing LDS have high triglyceride
levels. (7) These levels appear to predict early lipoatrophy manifestations
in first-line treated patients while specific antivirals may play a minor
role. Preliminary
studies of antiretroviral- naive individuals reveals high cholesterol
early in treatment followed by high triglycerides, hyperinsulinemia, and
decreased bone mineral density. U.S. studies also found an increased risk
of hyperglycemia in patients with hepatitis C virus (HCV) coinfection,
particularly
in those prescribed a PI. Collazos and others found that although hyperlipidemia
and HCV coinfection were associated with LDS, only the duration of HAART
was significantly predictive of LDS. (8) Vigano and colleagues recently
learned that both HIV-infected adults and adolescents with LDS show impaired
growth hormone secretion. (9).
|
|
|
Physical examination alone
can miss significant changes in body fat distribution, which can be altered
in HIV-positive men without clinical evidence of LDS. (10) Miller, Carr
and others conducted a cross-sectional study of 1,348 patients to establish
the prevalence, severity and factors associated with LDS. (11) Most study
participants had previously received or were on HAART regimens with at
least one PI. Patients were examined using dual energy X-ray absorptiometry
(DEXA) and single cut abdominal computerized tomography (CT) to quantify
regional and total body fat. Investigators learned that LDS was less in
antiretroviral-naive patients and most prominent in PI-experienced patients.
LDS was significantly associated with duration of therapy, elevated liver
enzymes, decreased testosterone levels, decreased skin-fold thickness,
lower levels of total and peripheral fat and higher levels of visceral
fat, increasing age, symptomatic HIV disease and effective viral suppression. |
|
|
|
"Most
study participants had previously received or were on HAART regimens with
at least one PI."
|
|
|
|
|
|
|
|
|
|
|
|
|
Defining LDS
Investigators at the Centers
for Disease Control and Prevention in Atlanta, Georgia used two definitions
to compare the prevalence of metabolic syndrome. (12) One definition was
proposed by the Third Report of the National Cholesterol Education Program
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol
in Adults (Adult Treatment Panel III) while the other definition noted
the World Health Organization as the source. Using data from the Third
National Health and Nutrition Examination Survey (NHANES III), among 8,608
participants, more than 86% were classified as either having or not having
the metabolic syndrome under both definitions. Ford and Giles conclude,
"A universally accepted definition of the metabolic syndrome is needed."
|
| |
| |
|
Copyright 2004 HIV ReSources,
Inc. Sharing this newsletter in any form with non-subscribers is strictly
prohibited. Library/Institution subscribers are permitted to share HIV
Nutrition Update html newsletter pages with up to five (5) employees or
volunteers. NO other redistribution allowed.
|
| |
Please Help To Keep
This Page Updated By Notifying
The Webmaster
If You Find A Link That's Outdated!
|
| |
HIV ReSources, Inc.
PO Box 39385
Fort Lauderdale, FL
33339-9385
USA
|
| |
© 2004
HIV ReSources, Inc.
Any use of the
information presented herein is done strictly at your own risk.
No responsibility
is implied or intended on the part of HIV ReSources Inc,
the editor,
or the publisher. Information on this site should not
be construed
as an endorsement of any kind.
|
| |
|
2/1/2004
|
|
|
|
|
