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Effects of Metformin Or Gemfibrozil on the Lipodystrophy of HIV-Infected Patients Receiving Protease Inhibitors
- Source :
- Antiviral Therapy. 8:403-410
- Publication Year :
- 2002
- Publisher :
- SAGE Publications, 2002.
-
Abstract
- Background Hypertriglyceridaemia and insulin resistance are common in HIV-infected patients treated with protease inhibitors, particularly in those with lipodystrophy. Whether a therapeutic approach addressed to those metabolic abnormalities may have any impact on body fat is not clear. Methods Patients on stable antiretroviral therapy containing protease inhibitors, with abdominal obesity defined by increased waist-to-hip ratio, and plasma triglycerides >200 mg/dl, were randomized to receive blind medication consisting of metformin 850 mg, gemfibrozil 600 mg or placebo every 12 h for 1 year. Weight, height, waist and hip were measured, and fasting blood analyses, including at least CD4 cell count, plasma HIV-1 RNA, lactate, glucose, insulin, triglycerides, total, HDL and LDL cholesterol were performed at baseline and every 3 months. An oral glucose tolerance test, and assessments of total and regional fat by bioimpedance analysis and sonography, respectively, were also done at baseline, 6 and 12 months. Results One-hundred-and-eight patients were randomized to placebo ( n=36), gemfibrozil ( n=37) or metformin ( n=35). There was absolute loss of total and regional fat in the three arms without significant changes in the waist-to-hip ratio. However, the loss of fat in patients on gemfibrozil was significantly lower than in patients on placebo. No patient discontinued study drugs due to adverse effects. Conclusion In this population of HIV-infected patients, there was a loss of fat along time. The finding of relative preservation of fat associated with gemfibrozil therapy deserves further investigation in the search of potential effective therapies for lipodystrophy in HIV-infected subjects.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Population
HIV Infections
Placebo
Gastroenterology
Insulin resistance
Double-Blind Method
Antiretroviral Therapy, Highly Active
Internal medicine
medicine
Humans
Hypoglycemic Agents
Gemfibrozil
Pharmacology (medical)
Prospective Studies
education
Abdominal obesity
Hypolipidemic Agents
Pharmacology
education.field_of_study
business.industry
HIV-Associated Lipodystrophy Syndrome
Insulin
HIV Protease Inhibitors
medicine.disease
Metformin
Treatment Outcome
Infectious Diseases
Endocrinology
Body Constitution
Female
Lipodystrophy
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 20402058 and 13596535
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Antiviral Therapy
- Accession number :
- edsair.doi.dedup.....2841a41ce32a32d857f794838f737f11