ObjectivesTreated HIV-1-infected patients with lipodystrophy often develop insulin resistance and proatherogenic dyslipidaemia. Zinc alpha-2 glycoprotein (ZAG) is a recently characterized adipokine which has been shown to be involved in the development of obesity and metabolic syndrome in uninfected subjects. We assessed the relationship between circulating ZAG levels and metabolic derangements in HIV-1-infected patients receiving antiretroviral drugs.
MethodsPlasma ZAG levels were assessed in 222 individuals: 166 HIV-1-infected patients treated with antiretroviral drugs (77 with lipodystrophy and 89 without lipodystrophy) and 56 uninfected controls. Plasma ZAG levels were assessed by enzyme-linked immunosorbent assay (ELISA) and were correlated with fat distribution abnormalities and metabolic parameters.
ResultsHIV-1-infected patients had lower plasma ZAG levels compared with uninfected controls (P < 0.001). No differences were found in ZAG plasma levels according to the presence of lipodystrophy, components of the metabolic syndrome or type of antiretroviral treatment regimen. Circulating ZAG levels were strongly determined by high-density lipoprotein cholesterol (HDLc) in men (B = 0.644; P < 0.001) and showed a positive correlation with total cholesterol (r = 0.312; P < 0.001) and HDLc (r = 0.216; P = 0.005).
ConclusionsHIV-1-infected patients have lower plasma ZAG levels than uninfected controls. In infected patients, plasma ZAG levels are in close relationship with total cholesterol and HDLc.Keywords: antiretroviral drugs, dyslipidaemia, HIV, lipodystrophy, metabolic syndrome, zinc alpha-2 glycoprotein
Accepted 21 October 2011
IntroductionProlonged use of antiretroviral drugs in HIV-1-infected patients is associated with several toxicities that limit their success. Among chronic toxicities, the appearance of the so-called lipodystrophy syndrome is of concern. Lipodystrophy includes a series of body morphological changes consisting of peripheral fat atrophy, truncal fat accumulation or both [1]. Lipodystrophy is not a merely aesthetic abnormality; unfortunately it is often Adipose tissue, in addition to its well-known role in lipid storage, is an important secretory organ. Adipokine deregulation is known to be involved in the aetiology of IR and metabolic syndrome (MS) in uninfected subjects, but the relationship between adipokines, lipodystrophy and its metabolic complications is a subject of controversy [4][5][6]. Recently, abnormalities in circulating levels of several adipokines, such as leptin and adiponectin, have been described in individuals with HIV-1-related lipodystrophy [7]. Zinc alpha-2 glycoprotein (ZAG) is a recently characterized adipokine that is a focus of special interest. This protein appears to be involved in lipid metabolism and body weight regulation and it may also be involved in the development of IR. In contrast to other adipokines, ZAG gene expression, similarly to expression of the adiponectin gene, is reduced in obesity [8][9][10]. However, it is unclear whether circulating leve...