Adiponectin and Leptin Levels in HIV-Infected Subjects With Insulin Resistance and Body Fat Redistribution

Abstract

In this study, we sought to determine the relationship between serum levels of leptin and adiponectin (Acrp30) in patients with HIV-associated lipodystrophy (HIV-LD). Three groups of subjects were studied; HIV-positive subjects with lipodystrophy (HIV-LD; n = 22), HIV-positive subjects without lipodystrophy (HIV; n = 17), and ethnicity- and body mass index-matched healthy control subjects (n = 20). Although total body fat from dual energy x-ray absorptiometry was similar in all three groups, the HIV-LD group had a significantly lower mean proportion of body fat in the limbs +/- SEM (37.2% +/- 2.2%) than either controls (49.8% +/- 1.5%) or HIV subjects (45.7% +/- 2.0%). The HIV-LD group also had the lowest mean insulin sensitivity +/- SEM (5.11 +/- 0.59 mg of glucose/[kg of lean body mass. min] vs. 10.2 +/- 0.72 mg of glucose/[kg of lean body mass. min] in controls and 8.64 +/- 0.69 mg of glucose/[kg of lean body mass. min] in the HIV group). Leptin levels were similar in all three groups and were significantly correlated to total body fat (r = 0.86; p<.001), but these levels did not correlate with either insulin sensitivity or limb fat. Mean Acrp30 levels +/- SEM were lowest in the HIV-LD group (5.43 +/- 0.44 microg/mL vs. 11.2 +/- 1.4 microg/mL in the HIV group and 14.9 +/- 1.8 microg/mL in control subjects). Further, Acrp30 levels were positively correlated with insulin sensitivity (r = 0.610; p <.001) and limb fat (r = 0.483; p <.001). However, the correlation between limb fat and insulin sensitivity disappeared when Acrp30 level and other potential mediators were removed from the association, suggesting that a deficiency in Acrp30 in subjects with HIV-LD may be part of the mechanism for the reduced insulin sensitivity.

Adiponectin: a relevant player in PPARγ-agonist-mediated improvements in hepatic insulin sensitivity?

“…Hotta et al 31 later reported a similar reduction of adiponectin levels in type 2 diabetic patients, independent of body mass index (BMI, kg/ m 2 ). More recently, Weyer et al 32 and Mynarcik et al 33 confirmed the association of obesity and type 2 diabetes with hypoadiponectinemia in Pima Indians and in HIV-positive patients. In ob/ob mice, adiponectin mRNA levels are downregulated as well.…”

Relationship of Body Composition, Metabolic Status, Antiretroviral Use, and HIV Disease Factors to Endothelial Dysfunction in HIV-Infected Subjects

“…[18][19][20][21][22][23] Physician-defined lipodystrophy was associated with an increased risk of myocardial infarction in a recent large prospective study. 3 However, formal body composition measures have not been included in any study of endothelial function in HIVinfected patients.…”

Leptin and Adiponectin in the HIV Associated Metabolic Syndrome: Physiologic and Therapeutic Implications

“…Leptin and the HIV associated metabolic syndrome: Fasting leptin levels have been shown to correlate well with total body fat concentrations in HIV-infected patients [53][54][55] . An association between limb fat loss and low leptin levels as well as other metabolic abnormalities in HIV patients has been published [56] however other studies failed to show such associations likely due to lack of stratification of patients by type of lipodystrophic body changes [57,58] .…”