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Mechanism of lipid disorder in HIV infection: apolipoprotein-B kinetics, fat distribution, insulin resistance and adipocytokines in patients taking protease inhibitors or non-nucleoside reverse transcriptase inhibitors

Das, Satyajit (2010)
M.D. thesis, University of Birmingham.

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Abstract

The relationship between antiretroviral treatment of HIV infection, body fat distribution, insulin resistance (HOMA), adipocytokine and apolipoprotein-B (apoB) kinetics was investigated in 12 HIV negative controls and 55 HIV-infected patients including antiretroviral treatment-naïve patients (n=15) and patients taking two nucleoside analogues plus either a protease inhibitor (PI, n=15) or non-nucleoside reverse transcriptase inhibitor (NNRTI, n = 25). The HIV positive treatment groups had mild dyslipidaemia. The apo-B fractional clearance rate (FCR) was reduced in the HIV positive groups. Peripheral fat was lower in treated patients and correlated with duration of therapy. There was a positive correlation between peripheral fat and apo-B clearance rate and a negative correlation with apo-B pool size. Adiponectin was reduced in all HIV positive groups and correlated positively with HDL-cholesterol, apo-B FCR and limb fat and correlated negatively with plasma triglycerides and HOMA. In a linear regression model which included HOMA, adiponectin level but not HOMA was predictive of apo-B FCR and HDL cholesterol. These results suggest that mild dyslipidaemia resulting from antiretroviral therapy is due to a decrease in apo-B FCR which is strongly related to loss of peripheral fat. Adiponectin may have a direct effect on lipoprotein metabolism which may be independent of insulin.

Type of Work:M.D. thesis.
Supervisor(s):Shahmanesh, Mohsen and Waring, Rosemery and Cramb, Rob
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Medicine
Subjects:RD Surgery
RC Internal medicine
Institution:University of Birmingham
ID Code:1475
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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