scholarly journals Markedly Diminished Lipolysis and Partial Restoration of Glucose Metabolism, without Changes in Fat Distribution after Extended Discontinuation of Protease Inhibitors in Severe Lipodystrophic Human Immunodeficient Virus-1-Infected Patients

2004 ◽  
Vol 89 (7) ◽  
pp. 3554-3560 ◽  
Author(s):  
Marc van der Valk ◽  
Gideon Allick ◽  
Gerrit Jan Weverling ◽  
Johannes A. Romijn ◽  
Mariette T. Ackermans ◽  
...  
Keyword(s):  
Glucose Production ◽  
Fat Distribution ◽  
Dual Energy ◽  
Glucose Disposal ◽  
Computed Tomography Scan ◽  
X Ray ◽  
Lipodystrophy Syndrome ◽  
Total Glucose ◽  
Tomography Scan ◽  
Hiv 1

Abstract Treatment for HIV-1 infection is often complicated by a lipodystrophy syndrome associated with insulin resistance and an elevated rate of lipolysis. In eight HIV-1 infected men with lipodystrophy syndrome, we studied the effects of replacement of protease inhibitor (PI) by abacavir on insulin sensitivity and lipolysis by hyperinsulinemic euglycemic clamp and on fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan. Glucose metabolism and lipolysis were assessed by tracer dilution employing [6,6-2H2]glucose and [2H5]glycerol, respectively. Data are expressed as mean ± sd or 95% confidence interval (CI), as appropriate. There were no significant changes in fat distribution assessed by dual-energy x-ray absorptiometry and computed tomography scan at wk 36 and wk 96. The fasting total glucose production decreased from 16.1 ± 2.5 at study entry by 1.1 (range, −2.1 to −0.1) to 15.0 ± 1.5 μmol/kg·min after PI withdrawal at wk 36 (n = 8). In an analysis restricted to the patients on treatment at wk 96 (n = 6), the decrease was 0.9 (range, −2.1 to 0.3) μmol/kg·min. During insulin infusion, glucose oxidation (as percent of total glucose disposal) increased from 36.8 ± 12.7% by 11.0% (range, 1.3–20.8) to 47.9 ± 13.9% in the wk 36 analysis. In the analysis restricted to the patients on treatment at wk 96 (n = 6) the increase was 7.7 (−4.0 to 19.4)%. Fasting lipolysis decreased from 2.7 ± 0.6 μmol/kg·min by 0.9 (−1.6 to −0.2) to 1.8 ± 0.3 μmol/kg·min in the wk-96 analysis (n = 6). The replacement of the studied PIs by abacavir in severe lipodystrophic HIV-1-infected patients results in a marked reduction of lipolysis. In contrast, fasting glucose production and insulin-stimulated glucose oxidation improve moderately, whereas insulin-stimulated glucose disposal and fat distribution do not change.

REGIONAL FAT DISTRIBUTION ANALYSIS TECHNIQUES: DUAL ENERGY X-RAY ABSORPTIOMETRY VERSUS CONVENTIONAL WAIST-TO-HIP CIRCUMFERENCE RATIO

1995 ◽  
Vol 27 (Supplement) ◽  
pp. S117
Author(s):  
K. T. Farrell-Lee ◽  
D. L. Alekel ◽  
C. B. Christ ◽  
J. L. Clasey ◽  
P. C. Fehling ◽  
...  
Keyword(s):  
Fat Distribution ◽  
Dual Energy ◽  
Distribution Analysis ◽  
Hip Circumference ◽  
X Ray ◽  
Analysis Techniques ◽  
Regional Fat Distribution

scholarly journals The Rate of Glucose Appearance Is Related to Postprandial Glucose and Insulin Responses in Adults: A Systematic Review and Meta-analysis of Stable Isotope Studies

2019 ◽  
Vol 149 (11) ◽  
pp. 1896-1903 ◽  
Author(s):  
Hanny M Boers ◽  
Marjan Alssema ◽  
David J Mela ◽  
Harry P F Peters ◽  
Roel J Vonk ◽  
...  
Keyword(s):  
Stable Isotope ◽  
Meta Analysis ◽  
Glucose Production ◽  
Postprandial Glucose ◽  
Peripheral Circulation ◽  
Endogenous Glucose Production ◽  
Glucose Disposal ◽  
Cochrane Library ◽  
Circulation Rate ◽  
Total Glucose

Abstract Background It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate digestion). However, changes in the rate of appearance of glucose in the peripheral circulation [rate of appearance of exogenous glucose (RaE)] may be accompanied by changes in endogenous glucose production (EGP) and the rate of disappearance of total glucose into tissues (RdT). The quantitative relationships between reductions in RaE and PPG/PPI levels are unclear. Objectives The objective was to perform a meta-analysis to quantify the effect of changes in RaE on changes in PPG and PPI levels (primary) and EGP and RdT (secondary). Methods We systematically searched the Scopus, Medline, and Cochrane library databases through 10 January 2019 for randomized, controlled, carbohydrate-rich interventions that aimed to reduce RaE in humans, measured using dual or triple stable isotope methods. The 2-h net incremental AUCs for all variables were extracted or calculated. Relationships between RaE and outcomes were quantified by weighted regression analyses. Results There were 12 articles, including 17 comparisons, that satisfied the inclusion criteria. The subjects were mainly men (60%), with age and BMI ranges of 18–40 y and 20.0–27.5 kg/m2, respectively. A 10% reduction in RaE was associated with reductions in PPG levels, PPI levels, and the RdT of 7% (95% CI: 2%, 12%; P = 0.010), 8% (95% CI: 2%, 13%; P = 0.012), and 11% (95% CI: 4%, 17%; P = 0.005), respectively, but was not significantly associated with a change in EGP (13%; 95% CI: −7%, 33%; P = 0.176). All fluxes together explained 70% and 26% of the variances in PPG and PPI levels, respectively. Conclusions In adults, reducing glucose RaE by diet is associated with significant reductions in PPG levels, PPI levels, and the rate of glucose disposal. This trial was registered in the PROSPERO database with identifier CRD42018084824.

A rosiglitazone-induced increase in adiponectin does not improve glucose metabolism in HIV-infected patients with overt lipoatrophy

2009 ◽  
Vol 297 (5) ◽  
pp. E1097-E1104 ◽  
Author(s):  
Regje M. E. Blümer ◽  
Marc van der Valk ◽  
Mariette Ackermans ◽  
Erik Endert ◽  
Mireille J. Serlie ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Body Fat ◽  
Statistical Power ◽  
Controlled Trial ◽  
Glucose Production ◽  
Fat Distribution ◽  
Body Fat Distribution ◽  
Glucose Disposal ◽  
Total Adiponectin ◽  
Hiv Lipodystrophy

HIV-infected patients on antiretroviral therapy frequently develop changes in body fat distribution and disturbances in glucose metabolism, associated with reduced adiponectin levels. Because adiponectin, principally the high-molecular-weight (HMW) form, has insulin-sensitizing properties, we investigated the effects of an increase in adiponectin on glucose metabolism in HIV-lipodystrophy. In this randomized, double-blind, placebo-controlled trial, we included HIV-1-infected patients with severe lipoatrophy, with an undetectable viral load and who had received neither protease inhibitors nor stavudine for ≥6 mo. Patients were randomized to rosiglitazone [8 mg daily ( n = 8)] to increase adiponectin levels or placebo ( n = 5) for 16 wk. Peripheral glucose disposal, glucose production, and lipolysis were measured after an overnight fast and during a hyperinsulinemic-euglycemic clamp using stable isotopes. Body composition was assessed by computed tomography and dual-energy X-ray absorptiometry. Although body fat distribution was unaffected, rosiglitazone increased total plasma adiponectin levels by 107% ( P < 0.02) and the ratio of HMW to total adiponectin by 73% ( P < 0.001). In the placebo group, neither total adiponectin levels ( P = 0.62) nor the ratio of HMW to total adiponectin changed ( P = 0.94). The marked increase in adiponectin induced by rosiglitazone was not associated with significant changes in basal endogenous glucose production ( P = 0.90), basal lipolysis ( P = 0.90), insulin-mediated suppression of glucose production ( P = 0.17) and lipolysis ( P = 0.54) nor with changes in peripheral glucose disposal ( P = 0.13). Acknowledging the limited statistical power of our small study, these findings, if confirmed by larger studies, could question the importance of adiponectin in regulating glucose metabolism in HIV-lipodystrophy.

The relationship between coronary atherosclerosis and body fat distribution measured using dual energy X-ray absorptiometry

2016 ◽  
Vol 248 ◽  
pp. 190-195 ◽  
Author(s):  
Se-Jun Park ◽  
Hyoung-Mo Yang ◽  
Kyoung-Woo Seo ◽  
So-Yeon Choi ◽  
Byoung-Joo Choi ◽  
...  
Keyword(s):  
Body Fat ◽  
Coronary Atherosclerosis ◽  
Fat Distribution ◽  
Dual Energy ◽  
Body Fat Distribution ◽  
X Ray ◽  
The Relationship

scholarly journals Methods for nurses to measure body composition

2011 ◽  
Vol 19 (4) ◽  
pp. 1033-1038 ◽  
Author(s):  
Jose Maria Moran ◽  
Jesus Maria Lavado-Garcia ◽  
Juan Diego Pedrera-Zamorano
Keyword(s):  
Body Composition ◽  
Fat Distribution ◽  
Dual Energy ◽  
Traditional Methods ◽  
X Ray ◽  
Skin Fold

Among the methods available for assessing body composition, traditional methods like hydrodensitometry and skin-fold measurements are well known. In this review, we focus on the impedance and interactance methods, which use systems that are usually inexpensive, easily transportable and simple to operate. We also discuss the usefulness of dual energy X-ray absorptiometry, particularly for the measurement of fat distribution. Nurses need to be skilled in the use of the equipment and familiar with the techniques.

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