Insulin resistance and HIV infection: a review

被引:39
作者
Aboud, M.
Elgalib, A.
Kulasegaram, R.
Peters, B.
机构
[1] Guys & St Thomas NHS Fdn Trust, Genitourinary Dept, London, England
[2] Kings Coll London, Acad Dept HIV & STDs, Sch Med, London WC2R 2LS, England
关键词
D O I
10.1111/j.1742-1241.2006.01267.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Highly active antiretroviral therapy (HAART) has markedly improved the prognosis of people with HIV infection. However, there are long-term side effects associated with HAART. Alterations in metabolic parameters are common and include hyperlipidaemia and insulin resistance (IR), either in isolation or as part of the lipodystrophy and metabolic syndromes. Insulin resistance is common in HIV-infected people, particularly among those being treated with protease inhibitor therapy. The prevalence of hyperglycaemia and diabetes mellitus is significantly higher in people with HIV infection being treated with antiretrovirals (ARVs), as compared with the general population. Hyperglycaemia is an important risk factor for the development of secondary pathology, including cardiovascular disease. It is therefore important to consider the effects of IR in HIV-infected individuals, and take measures to prevent or manage it appropriately. There is limited evidence for the benefit of pharmacological interventions for IR alone although the metabolic changes and body shape changes of lipodystrophy might benefit from the combined use of metformin with exercise. At present, therefore, it is best to concentrate on preventative measures, including lifestyle modification, the careful selection of ARV drugs, and changing drug combinations where appropriate.
引用
收藏
页码:463 / 472
页数:10
相关论文
共 76 条
[1]   Efficacy and safety of troglitazone in the treatment of lipodystrophy syndromes [J].
Arioglu, E ;
Duncan-Morin, J ;
Sebring, N ;
Rother, KI ;
Gottlieb, N ;
Lieberman, J ;
Herion, D ;
Kleiner, DE ;
Reynolds, J ;
Premkumar, A ;
Sumner, AE ;
Hoofnagle, J ;
Reitman, ML ;
Taylor, SI .
ANNALS OF INTERNAL MEDICINE, 2000, 133 (04) :263-274
[2]   Insulin resistance:: an independent risk factor for cardiovascular disease? [J].
Balkau, B ;
Eschwège, E .
DIABETES OBESITY & METABOLISM, 1999, 1 :S23-S31
[3]   The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity [J].
Barnard, ND ;
Scialli, AR ;
Turner-McGrievy, G ;
Lanou, AJ ;
Glass, J .
AMERICAN JOURNAL OF MEDICINE, 2005, 118 (09) :991-997
[4]   Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors [J].
Behrens, G ;
Dejam, A ;
Schmidt, H ;
Balks, HJ ;
Brabant, G ;
Körner, T ;
Stoll, M ;
Schmidt, RE .
AIDS, 1999, 13 (10) :F63-F70
[5]   Impaired glucose phosphorylation and transport in skeletal muscle cause insulin resistance in HIV-1-infected patients with lipodystrophy [J].
Behrens, GMN ;
Boerner, AR ;
Weber, K ;
van den Hoff, J ;
Ockenga, J ;
Brabant, G ;
Schmidt, RE .
JOURNAL OF CLINICAL INVESTIGATION, 2002, 110 (09) :1319-1327
[6]   Influence of protease inhibitor therapy on lipoprotein metabolism [J].
Berthold, HK ;
Parhofer, KG ;
Ritter, MM ;
Addo, M ;
Wasmuth, JC ;
Schliefer, K ;
Spengler, U ;
Rockstroh, JK .
JOURNAL OF INTERNAL MEDICINE, 1999, 246 (06) :567-575
[7]   Apoprotein C-III and E-containing lipoparticles are markedly increased in HIV-infected patients treated with protease inhibitors:: Association with the development of lipodystrophy [J].
Bonnet, E ;
Ruidavets, JB ;
Tuech, J ;
Ferrières, J ;
Collet, X ;
Fauvel, J ;
Massip, P ;
Perret, B .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2001, 86 (01) :296-302
[8]  
BROWN TT, 2004, 11 C RETR OPP INF FE
[9]  
Caldwell SH, 2001, AM J GASTROENTEROL, V96, P519
[10]   A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors [J].
Carr, A ;
Samaras, K ;
Burton, S ;
Law, M ;
Freund, J ;
Chisholm, DJ ;
Cooper, DA .
AIDS, 1998, 12 (07) :F51-F58