Liver Triglyceride Content in HIV-1-Infected Patients on Combination Antiretroviral Therapy Studied with 1H-MR Spectroscopy
Liver Triglyceride Content in HIV-1-Infected Patients on Combination Antiretroviral Therapy Studied with 1H-MR Spectroscopy
复制标题
使用 1H-MR 波谱研究接受联合抗逆转录病毒治疗的 HIV-1 感染患者的肝脏甘油三酯含量
作者：
À. Moreno;P. Domingo;J. Pujol;F. Blanco;J. Arroyo;M. Sambeat
目的应用质子磁共振波谱技术对接受高效抗逆转录病毒治疗(HAART)的HIV-1感染者的肝脏甘油三酯含量进行探索性评价，探讨HAART本身及其引起的生化和生理指标变化与肝脏脂肪含量的关系。方法采用水非抑制单体素质子谱技术，对29例首次HAART治疗的HIV-1感染者肝细胞内甘油三酯含量进行了测定。其他测量包括体重指数、腰臀比、脂肪营养不良评估和详细的血液生化分析。用相关分析和回归分析研究细胞内甘油三酯与相关描述性变量、治疗变量和生化变量之间的关系。结果58.6%的患者可检出肝内甘油三酯，13.8%的患者甘油三酯含量与肝脏脂肪变性相符。许多变量(体重指数、腰臀比、PI累积暴露量、乳酸、胰岛素、用稳态模型评估法[HOMA-R指数]测量的胰岛素抵抗、酸碱度、总甘油三酯、高密度脂蛋白胆固醇和极低密度脂蛋白胆固醇)与甘油三酸酯的含量分别相关。逐步多元回归分析显示，胰岛素或HOMA-R指数与极低密度脂蛋白胆固醇的组合可解释甘油三酯肝脏变异的50.2%。代谢综合征成分(胰岛素抵抗、血脂异常和中心性肥胖)的伴随存在与肝内甘油三酯含量呈正相关。结论肝内甘油三酯沉积是HIV-1感染患者接受HAART治疗的常见特征。与沉积物相关的生化和生理因素的连贯多因素组合表明，累积接触PI可能是一种可能的触发事件。
Objective To carry out an exploratory evaluation of liver triglyceride content in HIV-1-infected patients receiving highly active antiretroviral therapy (HAART) using proton magnetic resonance spectroscopy and to study how both the treatment itself and the biochemical and physiological variables in which the treatment causes alterations are related to liver fat content. Methods Intracellular hepatic triglyceride content was determined in 29 HIV-1-infected patients on their first HAART regime by means of localized water-unsuppressed single voxel proton spectra. Other measurements were body mass index, waist-to-hip ratio, lipodystrophy assessment and a detailed blood biochemical analysis. The relationship between intracellular hepatic triglycerides and relevant descriptive, treatment and biochemical variables was studied by correlation and regression analysis. Results Intrahepatic triglycerides were detected in 58.6% of the patients and 13.8% showed a triglyceride content compatible with liver steatosis. Many variables (body mass index, waist-to-hip ratio, cumulative exposure to PIs, lactate, insulin, insulin resistance measured by the homeostasis model assessment method [HOMA-R index], pH, total triglycerides, high density lipoprotein cholesterol and very low density lipoprotein [VLDL] cholesterol) correlated individually with the amount of triglycerides. Stepwise multiple regression analysis showed that the combination of insulin or HOMA-R index and VLDL cholesterol accounted for up to 50.2% of the triglyceride liver variance. A positive relationship was found between the concomitant presence of the metabolic syndrome components (insulin resistance, dyslipidaemia and central obesity) and intrahepatic triglyceride content. Conclusions The study showed that intrahepatic triglyceride deposit appears to be a frequent feature of HIV-1-infected patients receiving HAART. A coherent multifactorial combination of biochemical and physiological factors associated with the deposit suggested that cumulative exposure to PIs might be a possible trigger event.
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影响因子：
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作者：
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DOI：
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