| Immune deficiency could be an early risk factor for altered insulin sensitivity in antiretroviral-naive HIV-1-infected patients: the ANRS COPANA cohort. | |
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MedLine Citation:
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PMID: 22267473 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The relationships between immunovirological status, inflammatory markers, insulin resistance and fat distribution have not been studied in recently diagnosed (<1 year) antiretroviral-naive HIV-1-infected patients. METHODS: We studied 214 antiretroviral-naive patients at enrolment in the metabolic substudy of the ANRS COPANA cohort. We measured clinical, immunovirological and inflammatory parameters, glucose/insulin during oral glucose tolerance test (OGTT), adipokines, subcutaneous and visceral fat surfaces (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT], assessed by computed tomography) and the body fat distribution based on dual-energy X-ray absorptiometry (DEXA). RESULTS: Median age was 36 years; 28% of the patients were female and 35% of sub-Saharan origin; 20% had low CD4(+) T-cell counts (≤200/mm(3)). Patients with low CD4(+) T-cell counts were older and more frequently of sub-Saharan Africa origin, had lower body mass index (BMI) but no different SAT/VAT ratio and fat distribution than other patients. They also had lower total, low-density lipoprotein and high-density lipoprotein cholesterolaemia, higher triglyceridaemia and post-OGTT glycaemia, higher markers of insulin resistance (insulin during OGTT and homeostasis model assessment of insulin resistance) and of inflammation (high-sensitivity C-reactive protein, IL-6, tumour necrosis factor (TNF)-α, sTNFR1 and sTNFR2). After adjustment for age, sex, geographic origin, BMI and waist circumference, increased insulin resistance was not related to any inflammatory marker. In multivariate analysis, low CD4(+) T-cell count was an independent risk factor for altered insulin sensitivity (β-coefficient for HOMA-IR: +0.90; P=0.001; CD4(+) T-cell count >500/mm(3) as the reference), in addition to older age (β: +0.26 for a 10-year increase; P=0.01) and higher BMI (β: +0.07 for a 1-kg/m(2) increase; P=0.003). CONCLUSIONS: In ART-naive patients, severe immune deficiency but not inflammation could be an early risk factor for altered insulin sensitivity. |
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Authors:
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Faroudy Boufassa; Cécile Goujard; Jean-Paul Viard; Robert Carlier; Bénédicte Lefebvre; Patrick Yeni; Olivier Bouchaud; Jacqueline Capeau; Laurence Meyer; Corinne Vigouroux; |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Antiviral therapy Volume: 17 ISSN: 2040-2058 ISO Abbreviation: - Publication Date: 2012 |
Date Detail:
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Created Date: 2012-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815705 Medline TA: Antivir Ther Country: - |
Other Details:
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Languages: ENG Pagination: 91-100 Citation Subset: - |
Affiliation:
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Equipe 'VIH et IST', Centre de Recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Le Kremlin Bicêtre, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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