Background/Objective
In a previous report of HIV-infected patients with fat
redistribution, we found that recombinant human growth hormone (rhGH)
therapy reduced visceral adipose tissue (VAT) but increased insulin
resistance, and that the addition of rosiglitazone reversed the negative
effects of rhGH on insulin sensitivity. In this study, we sought to
determine the effects of recombinant human growth hormone (rhGH) and
rosiglitazone therapy on an array of inflammatory and fibrinolytic
markers.
Methods
72 patients with HIV-associated abdominal obesity and insulin
resistance were randomized to treatment with rhGH, rosiglitazone, the
combination of rhGH and rosiglitazone, or placebo for 12 weeks. Subjects
with plasma and serum samples available at weeks 0 (n = 63) and 12
(n = 46-48) were assessed for adiponectin, C-reactive protein (CRP),
homocysteine, interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis
factor alpha (TNF-α), interferon gamma (IFN-γ), fibrinogen,
plasminogen activator inhibitor-1 (PAI-1) antigen, and tissue plasminogen
activator (tPA) antigen.
Results
Treatment with both rosiglitazone alone and the combination of
rosiglitazone and rhGH for 12 weeks resulted in significant increases in
adiponectin levels from baseline. Adiponectin levels did not change
significantly in the rhGH alone arm. There were no significant changes in
the other biomarkers amongst the different treatment groups.
Discussion
In this study of HIV-infected patients with altered fat distribution,
treatment with rosiglitazone had beneficial effects on adiponectin
concentrations, an effect that was also seen with combination rosiglitazone
and rhGH. RhGH administration alone, however, did not demonstrate any
significant impact on adiponectin levels despite reductions in VAT.