Abstract
Objectives. Abnormalities of insulin sensitivity are increasingly reported in HIV infection.
Considering that cytokines (particularly TNF-α and IL-1β) can induce insulin resistance
in infections, we investigated the relationship between insulin sensitivity and cytokine
release from peripheral blood mononuclear cells (PBMCs) in HIV-infected patients.
Methods. Fourteen HIV-positive patients treated with dual-NRTI (nucleosidic reverse transcriptase
inhibitors) regimens, and fourteen healthy controls were studied. Insulin resistance
was assessed by homeostatic model for insulin resistance (HOMA-IR). Cytokine production
by PBMCs ex vivo was measured.
Results. Plasma glucose levels did not differ in HIV patients and in controls. Insulin concentrations
and HOMA-IR were significantly higher in HIV-infected patients than in controls (respectively,
11.4±4.3 vs. 7.86±1.1 mIU, P=0.005; 2.27±0.91 vs. 1.6±0.2, P=0.025). A significant positive linear correlation was observed between HOMA-IR and
TNF-α concentrations in the supernatants of unstimulated PBMC cultures in HIV patients
(![Math Eq]()
), but not in controls.
), but not in controls.Conclusions. Our results are in accordance with previous findings showing that insulin resistance
may indeed be present in PI-naive HIV patients, and suggest that either TNF-α, or
other mediators released in parallel with this cytokine may induce a state of insulin
resistance, unrelated to highly active antiviral treatments, in poorly controlled
HIV disease.
Keywords
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© 2003 The British Infection Society. Published by Elsevier Inc. All rights reserved.
