Important note: Information in this article was accurate in September 2006. The state of the art may have changed since the publication date.
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HIV/AIDS Lipodystrophy: Growth hormone replacement improves fasting lipid kinetics in HIV lipodystrophy syndrome
AIDSWEEKLY Plus; Monday, September 18, 2006
Staff Medical Writers
According to recent research from the United States, "HIV lipodystrophy syndrome (HLS) is characterized by accelerated lipolysis, inadequate fat oxidation, increased hepatic re-esterification, and a high frequency of growth hormone deficiency (GHD).
"The effect of growth hormone (GH) replacement on these lipid kinetic abnormalities is unknown. We aimed to measure the effects of physiologic GH replacement on lipid kinetics in men with HLS and GHD."
"Seven men with HLS and GHD were studied with the use of infusions of [13C1]palmitate, [2H5]glycerol, and [2H3]leucine to quantify total and net lipolysis, palmitate and free fatty acid (FFA) oxidation, and VLDL apolipoprotein B-100 synthesis before and after 6 months of GH replacement (maximum: 5 mcg*kg-1*D-1).
"GH replacement decreased the rates of total lipolysis [FFAtotal]rate of appearance (x±SE): from 4.80±1.24 to 3.32±0.76 mM FFA*kg fat-1*h-1; p<0.051 and net lipolysis (FFAnet rate of appearance: from 1.87±0.34 to 1.20±0.25 mM FFA*kg fat-1 h-1; p<0.05)," scientists reported.
"Fat oxidation decreased (from 0.28±0.02 to 0.20±0.02 mM FFA*kg lean body mass-1*H-1; p<0.002), as did the rate of appearance of FFAs available for intrahepatic re-esterification (from 0.50±0.13 to 0.29±0.09 mM FFA*kg fat-1*h-1; p<0.03).
"Fractional and absolute synthetic rates of VLDL apolipoprotein B-100 were unaltered. These kinetic changes were associated with a decrease in the waist-to-hip ratio but no significant change in fasting plasma lipid concentrations," researchers said.
S. Damico and colleagues at Baylor College of Medicine in Houston continued, "Fasting plasma glucose concentrations increased after treatment (from 5.2±0.2 to 5.8±0.3 mM/L; p<0.01)."
"Physiologic GH replacement has salutary effects on abnormal lipid kinetics in HLS. The effects are mediated by diminished lipolysis and hepatic re-esterification rather than by increased fat oxidation," investigators concluded.
Damico and colleagues published their study in American Journal of Clinical Nutrition (Physiologic growth hormone replacement improves fasting lipid kinetics in patients with HIV lipodystrophy syndrome. Am J Clin Nutr, 2006;84(1):204-211).
For additional information, contact A. Balasubramanyam, Baylor College of Medicine, Translat Metab Unit, Division Diabetes Endocrinol & Metab, Room 700B, 1 Baylor Plaza, Houston, TX 77030, USA.
Publisher contact information for the American Journal of Clinical Nutrition is: American Society Clinical Nutrition, 9650 Rockville Pike, Subscriptions, RM L-3300, Bethesda, MD 20814-3998, USA.
Keywords: Houston, Texas, United States, HIV/AIDS, Physiologic Growth Hormone Replacement, Lipodystrophy, Lipid Kinetics, Total Lipolysis.
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
D'Amico S, Shi J, Sekhar RV, et al., “Physiologic growth hormone replacement improves fasting lipid kinetics in patients with HIV lipodystrophy syndrome”, Am J Clin Nutr. 2006 Jul;84(1):204-11.
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