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Plasma homocysteine levels in HIV-infected men with and without lipodystrophy
Rafael Deminice1, Helena S Vassimon, Alcyone A Machado
1Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil; Department of Physical Education, Institute of Physical Education and Sport, State University of Londrina, Campus Universitário, Londrina, Paraná, Brazil.
Insights
HIV patients with lipodystrophy show higher homocysteine levels, linked to cardiovascular disease risk. Factors like HAART duration, insulin, and adiponectin influence these metabolic disturbances.
Area of Science:
- Endocrinology
- Cardiovascular Disease
- Infectious Disease
Background:
- Lipodystrophy syndrome in HIV patients is linked to increased cardiovascular disease (CVD) risk.
- Hyperhomocysteinemia is a known risk factor for CVD.
Purpose of the Study:
- To investigate homocysteine (Hcy) levels in men with HIV.
- To examine the association between Hcy levels and lipodystrophy syndrome factors in HIV-infected men.
Main Methods:
- Measured Hcy metabolism-related molecules in three groups: HIV+lipodystrophy (HIV+LIP), HIV without lipodystrophy (HIV), and healthy controls (C).
Main Results:
- Elevated plasma Hcy levels were observed in both HIV and HIV+LIP groups compared to controls.
- HIV patients had lower plasma vitamin B12 and folate levels.
- HIV+LIP men showed increased plasma total sulfur-containing amino acids and lower total plasma thiol compared to controls.
- Plasma Hcy correlated significantly with HAART duration, plasma insulin, and adiponectin levels.
Conclusions:
- HIV+LIP men exhibit greater susceptibility to Hcy metabolism disturbances than HIV men without lipodystrophy.
- HAART duration, elevated plasma insulin, and low adiponectin are implicated in Hcy metabolic disorders in this population.
Objective:
Lipodystrophy syndrome is an unexpected clinical manifestation in patients infected with HIV and might be a clinical marker of increased risk for cardiovascular diseases (CVDs). Because hyperhomocysteinemia has been associated with CVD, the goal of the present study was to investigate homocysteine (Hcy) levels and their association with the factors of lipodystrophy syndrome in men with HIV.
Methods:
Hcy metabolism-related molecules were determined in 13 men infected with HIV with lipodystrophy (HIV+LIP), 10 men with HIV without lipodystrophy (HIV), and 10 healthy controls (C).
Results:
Significant (P < 0.05) increased Hcy plasma levels were found in HIV (20.5%) and in HIV+LIP (35.2%) compared with the control group. Plasma levels of vitamin B12 (HIV, 26.5%; HIV+LIP, 28.8%) and folate (HIV, 39.1% and HIV+LIP, 49.4%) were significantly (P < 0.05) lower in the two groups of HIV patients compared with control. HIV+LIP men presented raised plasma total sulfur-containing amino acids (20.1%) and lower total plasma thiol (11.3%) than controls. The same was not observed in the HIV group. Spearman's correlation test revealed significant (P < 0.05) association between plasma Hcy and duration of highly active antiretroviral therapy (HAART) and plasma insulin, as well as plasma adiponectin levels.
Conclusion:
Our results demonstrated that HIV+LIP men were more susceptible to disturbances in Hcy metabolism compared with men infected with HIV without lipodystrophy characteristics. Duration of HAART treatment, elevated plasma insulin, and low levels of adiponectin seem to be relevant for the appearance of these Hcy metabolic disorders.
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