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Abstract
Abstract Background In HIV-infected patients on combination antiretroviral therapy (cART), lipodystrophy shares many similarities with metabolic syndrome, but only metabolic syndrome has objective classification criteria. We examined adipose tissue changes related to lipodystrophy and metabolic syndrome to clarify whether it may be acceptable to focus diagnosis on metabolic syndrome rather than lipodystrophy. Methods A cross-sectional study of 60 HIV-infected men on cART and 15 healthy men. We evaluated lipodystrophy (clinical assessment) and metabolic syndrome (JIS-2009). We compared adipocyte size, leukocyte infiltration, and gene expression in abdominal subcutaneous adipose tissue biopsies of patients with and without lipodystrophy, and with and without metabolic syndrome. Results Lipodystrophy was only associated with increased macrophage infiltration (P=0.04) and adiponectin mRNA (P=0.008), whereas metabolic syndrome was associated with larger adipocytes (P<0.0001), decreased expression of genes related to adipogenesis and adipocyte function (P-values between <0.0001-0.08), increased leptin mRNA (P=0.04), and a trend towards increased expression of inflammatory genes (P-values between 0.08-0.6). Conclusions Metabolic syndrome rather than lipodystrophy was associated with major unfavourable abdominal subcutaneous adipose tissue changes. In a clinical setting, it may be more relevant to focus on metabolic syndrome diagnosis in HIV-infected patients on cART with regards to adipose tissue dysfunction and risk of cardio-metabolic complications. Lipodystrophy, metabolic syndrome, adipose tissue, HIV-infection © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Journal
The Journal of Infectious Diseases – Oxford University Press
Published: May 17, 2018
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