Longitudinal evolution of HIV-1-associated lipodystrophy is correlated to serum cortisol:: DHEA ratio and IFN-α
Longitudinal evolution of HIV-1-associated lipodystrophy is correlated to serum cortisol:: DHEA ratio and IFN-α
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DOI：
10.1046/j.1365-2362.2002.01068.x
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发表时间：
2002-10-01
影响因子：
5.5
通讯作者：
Gougeon, ML
中科院分区：
文献类型：
--
作者：
Christeff, N;de Truchis, P;Gougeon, ML
背景 我们之前已经表明，HIV-1 相关脂肪营养不良 (LD) 中的脂质改变与血清脱氢表雄酮 (DHEA) 降低和皮质醇：DHEA 比率和 IFN-α 水平升高相关。 目的 在纵向研究中评估类固醇和细胞因子修饰是否与 LD 相关的身体变化和脂质改变的演变相关。 方法 对 34 名 HIV-1 阳性男性进行为期 32.5 +/- 4.0 个月的随访，分四个时间点进行测试。根据身体变化和人体测量结果将患者分为五组：LD阴性、最初LD阴性变为LD阳性、LD阳性不变、加重或改善。测量血清脂质、载脂蛋白、肾上腺类固醇和细胞因子，并与基线值进行比较。 结果（1）LD加重与血脂持续升高、血清DHEA降低、皮质醇：DHEA比值升高和持续高水平IFN-α相关。 (2) LD 的改善与血清脂质的正常化、血清 DHEA 的增加导致皮质醇：DHEA 比率的正常化以及 IFN-α 水平的正常化有关。 (3) 在 LD 阳性男性中，VLDL 胆固醇的演变与 DHEA 呈负相关（r = -0.56，P < 0.01），与皮质醇：DHEA 比率（r = 0.62，P < 0.004）和 IFN-α 呈正相关（r = 0.57，P < 0.01）。 (4)改用LD与血清DHEA下降有关。 (5)LD阴性的患者血脂正常，皮质醇和DHEA升高，皮质醇:DHEA比值正常，IFN-α水平正常。结论本研究表明，皮质醇:DHEA比值和血清IFN-α水平与LD的临床进展和致动脉粥样化脂质改变密切相关。
Background We have previously shown that lipid alterations in HIV-1-associated lipodystrophy (LD) are correlated with decreased serum dehydroepiandosterone (DHEA) and increased cortisol: DHEA ratio and IFN-alpha levels.Objective To evaluate in a longitudinal study whether steroid and cytokine modifications are associated with the evolution of physical changes and lipid alterations associated with LD.Methods Thirty-four HIV-1-positive men were followed during 32.5 +/- 4.0 months and tested at four time-points. The patients were subdivided into five groups according to physical changes and anthropometric measurements: LD-negative, initially LD-negative becoming LD-positive, LD-positive unchanged, aggravated or improved. Serum lipids, apolipoproteins, adrenal steroids and cytokines were measured and compared with baseline values.Results (1) LD aggravation is associated with persistent elevated lipids, a decrease in serum DHEA, an increase in cortisol: DHEA ratio and persistent high levels of IFN-alpha. (2) LD improvement is associated with normalization of serum lipids, an increase in serum DHEA leading to normalization in cortisol: DHEA ratio, and normalization of IFN-alpha levels. (3) In LD-positive men evolution of VLDL cholesterol is negatively correlated with DHEA (r = -0.56, P < 0.01) and positively with cortisol: DHEA ratio (r = 0.62, P < 0.004) and with IFN-alpha (r = 0.57, P < 0.01). (4) The switch to LD is associated with a decrease in serum DHEA. (5) Patients who remained LD-negative maintained normal lipids, elevated cortisol and DHEA, and normal cortisol: DHEA ratio and normal levels of IFN-alpha.Conclusions This study indicates that cortisol: DHEA ratio and serum IFN-alpha levels are closely associated with clinical evolution and atherogenic lipid alterations in LD.