The role of diet, exercise and smoking in dyslipidaemia in HIV‐infected patients with lipodystrophy

Abstract

Lipodystrophy in HIV-infected (LDHIV) patients receiving protease inhibitors (PIs) is associated with dyslipidaemia. Whether lifestyle factors play a role in dyslipidaemia in LDHIV subjects on PIs is not well characterized. MethodsA total of 45 LDHIV male and six LDHIV female patients on PIs were recruited, and data were collected on smoking, exercise, diet (by 3-day food record), and fasting levels of serum lipids and lipoproteins. The relationships between lifestyle factors and metabolic variables were analysed in male patients by Spearman's correlation test and the significant relationships were further analysed by adjusting for age, PI duration, and waist circumference by Spearman's partial correlation test. ResultsIn men, mean (AE standard deviation) serum concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C were 212 AE 70, 35 AE 7.3, 325 AE 230 and 169 AE 44 mg/dL, respectively. Sixty-seven percent of the men exercised regularly and 31.1% smoked. The reported diet was high in cholesterol (390 AE 212 mg) and percentage energy from saturated (12.2 AE 3.3%) and trans (2.4 AE 1.2%) fats, and low in soluble fibre (6.9 AE 2.3 g) compared with recent dietary guidelines. Following adjustments for the confounding variables, percentage energy intake from total protein and animal protein was positively related to TC (r 5 0.44, Po0.01 and r 5 0.37, Po0.05, respectively), TG (r 5 0.40, Po0.01 and r 5 0.46, Po0.01, respectively) and non-HDL-C (r 5 0.56, Po0.001 and r 5 0.49, Po0.01, respectively), that from trans fat was positively related to TG (r 5 0.34, Po0.05), and soluble fibre was negatively related to non-HDL-C (r 5 À 0.41, Po0.01). Moderate to heavy aerobic exercise tended to be associated with higher HDL-C (r 5 0.30, P 5 0.07) whereas smoking was not associated with any of the metabolic variables. ConclusionsIncreased intake of total protein, animal protein and trans fat, and reduced soluble fibre consumption contribute to dyslipidaemia in LDHIV subjects on PIs.Keywords: diet, dyslipidaemia, exercise, HIV, lipodystrophy, smoking In subjects not infected with HIV, lifestyle factors such as diet, physical activity and smoking contribute significantly to dyslipidaemia [10]. However, there is a paucity of data regarding the role of lifestyle factors in inducing dyslipidaemia in LDHIV individuals on PI-containing HAART. Previous studies [11][12][13] included not only HIV-infected subjects on PI therapy but also PI-naïve subjects. Also, two of these studies [11,12] did not examine or adjust for the role of exercise and smoking in dyslipidaemia. Furthermore, these studies [11][12][13] did not comprehensively examine the relationship between intakes of macronutrients and levels of lipids and lipoproteins. For example, Batterham et al.[11] evaluated only the role of total and saturated fat in dyslipidaemia. Hadigan et al.[12] did not study the role of unsaturated fats such as polyunsaturated, monounsaturated and trans fats. Gavrila et al. [13] did not ...

Factors Associated with Abdominal Obesity among HIV-infected Adults on Antiretroviral Therapy in Malaysia

“…Some study of positive HIV infected subjects under ARV medication showed that abdominal fat and mean WHR/WC were higher in HIV positive men (Jacobson et al 2005;Shah et al, 2005) or among HIV infected women (Jamie et al 2006). In this study abdominal obesity was more prevalent among the women but the difference was not significant.…”

Habitual Nutrient Intake in HIV-Infected Youth and Associations with HIV-Related Factors

“…and soluble, has been linked to a lower CVD risk and decreased progression to CVD in high-risk adults. 26 Adult HIV studies have also shown associations between trans fat intake and serum TG levels, 24 as well as between percentage calories derived from dietary fat and serum TC and TG. 46 Despite these findings previously found in adults, there were few meaningful associations between nutrient intake and lipid profiles in our cohort of HIV-infected youth.…”

“…6,7,[16][17][18][19][20][21][22][23] For example, HIVinfected individuals have an increased risk of cardiovascular disease (CVD) that has been shown to be associated with nutritional deficiencies in other populations as well as within the HIV population. [24][25][26] In addition, HIV-infected individuals are at an increased risk for lipid abnormalities and metabolic syndrome, which have been shown to improve with dietary intervention in the general population. 18,22,24,[26][27][28] Like HIV-infected adults, increased risk for CVD and metabolic abnormalities occur among HIV-infected youth.…”

“…[24][25][26] In addition, HIV-infected individuals are at an increased risk for lipid abnormalities and metabolic syndrome, which have been shown to improve with dietary intervention in the general population. 18,22,24,[26][27][28] Like HIV-infected adults, increased risk for CVD and metabolic abnormalities occur among HIV-infected youth. 18,22,[29][30][31][32] Combined with a rising prevalence of obesity in this population and higher nutritional risk due to growth and development demands, nutritional deficiencies in this population are particularly alarming.…”

Physical Activity Measurements Using Accelerometers and Pedometers in HIV-Infected People

“…For people who are living with HIV there are no specific exercise recommendations although it has been demonstrated that PA in this people is inversely related to numerous metabolic disorders like high level of insulin resistance and triglycerides, muscle wasting, depression, osteopenia or dyslipidemia between others [8][9][10][11][12]. As well as PA can improve quality of life and self-efficacy, increase the number of CD4 T-lymphocyte counts and high-density lipoproteins [13][14][15][16].…”