This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van Wijk, J. P. H. Articles by Hoepelman, I. M. Search for Related Content PubMed PubMed Citation Articles by van Wijk, J. P. H. Articles by Hoepelman, I. M. Related Collections Lipid Metabolism

In Vivo Evidence of Impaired Peripheral Fatty Acid Trapping in Patients with Human Immunodeficiency Virus-Associated Lipodystrophy

Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht (J.P.H.v.W., M.C.C., I.M.H.), 3508 GA Utrecht, The Netherlands; Department of Internal Medicine, St. Franciscus Gasthuis (M.C.C.), 3004 BA Rotterdam, The Netherlands; and Departments of Nephrology (E.J.P.d.K., T.J.R.) and Radiology (R.v.d.G.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands

Address all correspondence and requests for reprints to: Dr. Jeroen P. H. van Wijk, Departments of Internal Medicine and Infectious Disease, University Medical Center Utrecht, G02.402, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. E-mail: j.p.h.vanwijk{at}azu.nl.

The use of antiretroviral combination therapy in HIV has been associated with lipodystrophy and several metabolic risk factors. We postulated that patients with HIV-lipodystrophy have impaired adipose tissue free fatty acid (FFA) trapping and, consequently, increased hepatic FFA delivery. We investigated FFA, hydroxybutyric acid (HBA; reflecting hepatic FFA oxidation), and triglyceride (TG) changes after a high fat meal in HIV-infected males with (LIPO; n = 26) and without (NONLIPO; n = 12) lipodystrophy and in healthy males (n = 35). Because defective peripheral FFA trapping has been associated with impaired action of complement component 3 (C3), we also determined postprandial C3 concentrations. The LIPO group had higher homeostasis model assessment scores compared with the other groups. Areas under the curve (AUCs) for FFA, HBA, and TG were higher in the LIPO group than in the NONLIPO group or the controls. No differences in TG-AUC, FFA-AUC, and HBA-AUC were observed between the NONLIPO group and controls. In HIV-infected patients, FFA-AUC and HBA-AUC were inversely related to sc adipose tissue area. Plasma C3 showed a postprandial increase in healthy controls, but not in the HIV-infected groups. C3 was not related to body fat distribution, postprandial FFA, or HBA. The present data suggest disturbed postprandial FFA metabolism in patients with HIV-lipodystrophy, most likely due to inadequate incorporation of FFA into TG in sc adipose tissue, but do not support a major role for C3 in these patients. The higher postprandial HBA levels reflect increased hepatic FFA delivery and may aggravate insulin resistance and dyslipidemia, leading to increased cardiovascular risk.

This article has been cited by other articles:

				W. Guo, S. Wong, J. Pudney, R. Jasuja, N. Hua, L. Jiang, A. Miller, P. W. Hruz, J. A. Hamilton, and S. Bhasin Acipimox, an Inhibitor of Lipolysis, Attenuates Atherogenesis in LDLR-Null Mice Treated With HIV Protease Inhibitor Ritonavir Arterioscler Thromb Vasc Biol, December 1, 2009; 29(12): 2028 - 2032. [Abstract] [Full Text] [PDF]

				D. B. Savage, K. F. Petersen, and G. I. Shulman Disordered Lipid Metabolism and the Pathogenesis of Insulin Resistance Physiol Rev, April 1, 2007; 87(2): 507 - 520. [Abstract] [Full Text] [PDF]

				M. A.M. den Boer, J. F.P. Berbee, P. Reiss, M. van der Valk, P. J. Voshol, F. Kuipers, L. M. Havekes, P. C.N. Rensen, and J. A. Romijn Ritonavir Impairs Lipoprotein Lipase-Mediated Lipolysis and Decreases Uptake of Fatty Acids in Adipose Tissue Arterioscler Thromb Vasc Biol, January 1, 2006; 26(1): 124 - 129. [Abstract] [Full Text] [PDF]