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Am J Physiol Endocrinol Metab 286: E261-E271, 2004. First published October 7, 2003; doi:10.1152/ajpendo.00056.2003
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Increased systemic and adipose tissue cytokines in patients with HIV-associated lipodystrophy

Julia A. Johnson,1,2 Jeanine B. Albu,1,2,* Ellen S. Engelson,2 Susan K. Fried,3 Yoritaro Inada,2 Gabriel Ionescu,2 and Donald P. Kotler2,*

1Obesity Research Center and 2Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York 10025; and 3Department of Nutrition, Rutgers University, New Brunswick, New Jersey 08901

Submitted 7 February 2003 ; accepted in final form 29 September 2003

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-{alpha}, 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 and by whole body MRI. TNF-{alpha} 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.

human immunodeficiency virus; tumor necrosis factor-{alpha}; interleukin-6; lactate; glycerol; visceral adipose tissue


Address for reprint requests and other correspondence: J. A. Johnson, Obesity Research Center, Div. of Endocrinology, Diabetes and Nutrition, Dept. of Medicine, St. Luke's Roosevelt Hospital Center, 1111 Amsterdam Ave., New York, NY 10025 (E-mail: JAJohnso33{at}aol.com).




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