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1 Obesity Research Center, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, New York, NY, USA; Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, New York, NY, USA
2 Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, New York, NY, USA
3 Department of Nutrition, Rutgers University, New Brunswick, NJ, USA
* To whom correspondence should be addressed. E-mail: JAJohnso33{at}aol.com.
The lipodystrophy syndrome (adipose tissue redistribution and metabolic abnormalities) observed with highly active antiretroviral therapy (HAART) during human immunodeficiency
virus (HIV) infection may be related to increased proinflammatory cytokine activity. We measured acute cytokine (TNF
, IL-6, leptin), glycerol and lactate secretion from abdominal subcutaneous adipose tissue (SAT), and systemic cytokine levels, in HIV-infected subjects with
and without lipodystrophy (HIVL+ and HIVL-, respectively) and healthy non-HIV controls. Lipodystrophy was confirmed and characterized as adipose tissue redistribution in HIVL+
compared with HIVL- and Controls, by dual-energy X-ray absorptiometry (DXA) and by whole-body MRI. TNF secretion from abdominal SAT, and circulating levels of IL-6, soluble TNF receptors I and II, and insulin, were elevated in HIVL+ relative to HIVL- and/or Controls,
particularly in HIVL+ undergoing HAART. In the HIV-infected group as a whole, IL-6 secretion from abdominal SAT and serum IL-6 were positively associated with visceral fat and
were negatively associated with the relative amount of lower limb adipose tissue (P < 0.01). Decreased leptin and increased lactate secretion from abdominal SAT were specifically associated with HAART. In conclusion, increased cytokine secretion from adipose tissue and
increased systemic proinflammatory cytokine activity may play a significant role in the adipose tissue remodeling and/or the metabolic abnormalities associated with the HIV-lipodystrophy syndrome, in patients undergoing HAART.
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