Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 4, July-August, p. 539–549

Publication type: original article

Language: English

Impact of Antiretroviral Therapy on Selected Metabolic Disorders – Pilot Study

Monika Bociąga-Jasik1,A,B,C,D,F, Anna Polus2,G, Joanna Góralska2,C,G, Urszula Raźny2,G, Dominika Siedlecka2,G, Barbara Zapała2,G, Robert Chrzan3,G, Aleksander Garlicki1,E, Tomasz Mach1,E, Aldona Dembińska-Kieć2,A,E,F

1 Chair of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University, Collegium Medicum, Kraków, Poland

2 Department of Clinical Biochemistry, Jagiellonian University, Collegium Medicum, Kraków, Poland

3 Department of Radiology, Jagiellonian University, Collegium Medicum, Kraków, Poland

Abstract

Background. Taking into consideration the aging of HIV infected individuals, changes in the metabolism aggravated by the antiretroviral therapy significantly impact their health. Mechanisms responsible for lipodystrophy, dyslipidemia and insulin resistance (IR) occurrence have not been completely understood. Only recently, the free fatty acids (FFAs) metabolic turnover has become considered to be the independent risk factor for cardiovascular complications.
Material and Methods. We designed the follow-up study in which patients were recruited before the introduction of ARV therapy and then observed up to 1 year. The impact of ARV therapy on the development of metabolic complications, inflammation markers and changes in adipokines secretion was investigated. The fasting and postprandial responses of FFAs, triglycerides (TG), glucose, insulin and glucose-dependent insulinotropic peptide (GIP) were measured. Changes in body composition were followed by impedance and a CT scan of adipose tissue volume of the abdomen and thighs.
Results. Significant impact of ARV therapy on metabolic disturbances was reported. Not only fasting, but also postprandial levels of FFAs and TG were found to increase during the follow up.
Conclusion. The increased concentration of FFAs is suggested to be the triggering event in the development of hypertriglyceridemia and insulin resistance during ARV therapy. Changes in postprandial FFAs and TG during the follow up indicate the increasing risk of cardiovascular diseases. We conclude that modern ARV therapy during the period of 12 months does not induce changes in the fat distribution, although increased limb fat correlated with higher plasma leptin level, which may be the marker of increased risk of metabolic driven cardiovascular complications.

Key words

adipokines, FFAs, GIP, HIV, IL-6, postprandial test, TNFα.

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