Physiologic growth hormone replacement improves fasting lipid kinetics in patients with HIV lipodystrophy syndrome

Susana D'Amico, Jianjian Shi, Rajagopal V. Sekhar, Farook Jahoor, Kenneth J. Ellis, Khaleel Rehman, James Willis, Mario Maldonado, Ashok Balasubramanyam

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17 Scopus citations

Abstract

Background: HIV lipodystrophy syndrome (HLS) is characterized by accelerated lipolysis, inadequate fat oxidation, increased hepatic reesterification, and a high frequency of growth hormone deficiency (GHD). The effect of growth hormone (GH) replacement on these lipid kinetic abnormalities is unknown. Objective: We aimed to measure the effects of physiologic GH replacement on lipid kinetics in men with HLS and GHD. Design: Seven men with HLS and GHD were studied with the use of infusions of [13C 1]palmitate, [2H5]glycerol, and [ 2H3]leucine to quantify total and net lipolysis, palmitate and free fatty acid (FFA) oxidation, and VLDL apolipoprotein B-100 synthesis before and after 6 mo of GH replacement (maximum: 5 μg·kg -1·d-1). Results: GH replacement decreased the rates of total lipolysis [FFAtotal rate of appearance (x- ± SE): from 4.80 ± 1.24 to 3.32 ± 0.76 mmol FFA·kg fat-1·h-1; P < 0.05] and net lipolysis (FFA net rate of appearance: from 1.87 ± 0.34 to 1.20 ± 0.25 mmol FFA·kg fat-1·h-1; P < 0.05). Fat oxidation decreased (from 0.28 ± 0.02 to 0.20 ± 0.02 mmol FFA·kg lean body mass-1·h-1; P < 0.002), as did the rate of appearance of FFAs available for intrahepatic reesterification (from 0.50 ± 0.13 to 0.29 ± 0.09 mmol FFA·kg fat-1·h-1; P < 0.03). Fractional and absolute synthetic rates of VLDL apolipoprotein B-100 were unaltered. These kinetic changes were associated with a decrease in the waist-to-hip ratio but no significant change in fasting plasma lipid concentrations. Fasting plasma glucose concentrations increased after treatment (from 5.2 ± 0.2 to 5.8 ± 0.3 mmol/L; P < 0.01). Conclusions: Physiologic GH replacement has salutary effects on abnormal lipid kinetics in HLS. The effects are mediated by diminished lipolysis and hepatic reesterification rather than by increased fat oxidation.

Original languageEnglish (US)
Pages (from-to)204-211
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume84
Issue number1
StatePublished - Jul 1 2006

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Keywords

  • Adipocyte
  • Dyslipidemia
  • Fat redistribution
  • Insulin resistance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

D'Amico, S., Shi, J., Sekhar, R. V., Jahoor, F., Ellis, K. J., Rehman, K., Willis, J., Maldonado, M., & Balasubramanyam, A. (2006). Physiologic growth hormone replacement improves fasting lipid kinetics in patients with HIV lipodystrophy syndrome. American Journal of Clinical Nutrition, 84(1), 204-211.