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Papers In Press, published online ahead of print June 16, 2003
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service d'endocrinologie diabétologie, CHU du Bocage, Dijon cedex F-21034
Corresponding Author: jean-michel.petit{at}chu-dijon.fr
The aim of this study was to identify the first abnormalities of apolipoprotein B (apoB) metabolism in HIV-infected patients treated by antiretroviral therapy (ART) with protease inhibitors (PI). The influence of ART on the metabolism of apo B in VLDL, IDL, and LDL was investigated in six patients receiving dual nucleoside reverse transcriptase inhibitors (NRTI) and PI, and in five patients receiving NRTI and nevirapine. None of the patients had lipodystrophy. The study was performed in the fed state. Each subject received an intravenous injection of a 0.7 mg.kg-1 bolus of L-[1-13C]leucine, immediately followed by a 16-hour constant infusion at 0.7 mg.kg-1.h-1. The VLDL and IDL-apoB concentrations were significantly higher in PI-treated patients compared to non-PI-treated patients. The VLDL-apoB and IDL-apoB production rates were markedly higher in PI-treated patients compared to non-PI-treated patients (54.5 ± 30.1 vs. 30.9 ± 8.4 mg.kg-1.d-1, p=0.04 and 43.5 ± 20.0 vs. 18.7 ± 7.8 mg.kg-1.d-1, p=0.04, respectively). The VLDL apoB transfer rate to IDL was not significantly different in both group. In conclusion, our study shows that patients receiving ART with PI present altered metabolism of the VLDL-IDL-LDL chain compared to patient treated without PI. These data confirm that PI therapy is associated with a physiopathological mechanism for dyslipidemia besides the effect of lipodystrophy on lipid metabolism.
Revised on June 2, 2003
Accepted on June 16, 2003
Increased VLDL-apolipoprotein B and IDL-apolipoprotein B production rates in non lipodystrophic HIV-infected patients on a protease inhibitor containing regimen. A stable isotope kinetic study
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