Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides
Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides
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DOI：
10.1097/01.aids.0000183629.20041.bb
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发表时间：
2005-11-04
期刊：
影响因子：
3.8
通讯作者：
Mulligan, K
中科院分区：
文献类型：
--
作者：
Dubé, MP;Parker, RA;Mulligan, K
目的：确定抗逆转录病毒药物方案的特定成分是否与胰岛素抵抗、血脂异常和外周脂肪萎缩有关。方法：在一项多中心的因子设计试验中，对334名未经抗逆转录病毒治疗的hiv感染者进行了为期64周的代谢和身体组成变量的前瞻性测量，这些患者被随机分配接受奈非那韦、依非韦伦或两者联合齐多夫定/拉米夫定或二danosine/司他夫定治疗。分配给依非韦伦的受试者（n = 110）与分配给奈非那韦的受试者（n = 99）进行比较；分配给齐多夫定/拉米夫定的受试者（n = 154）与分配给二腺苷/司他夫定的受试者（n = 180）进行比较。157名受试者进行了连续双能x射线吸收仪（DEXA）扫描。结果：各组患者血脂指标均升高。与奈非那韦相比，依非韦伦组高密度脂蛋白（HDL）胆固醇的升高幅度更大。与齐多夫定/拉米夫定相比，司他夫定和二腺苷组总胆固醇、非高密度脂蛋白胆固醇和高密度脂蛋白胆固醇的升高幅度更大。在比较中，胰岛素抵抗没有差异。在最初的16周增加后，中位肢体脂肪减少。与齐多夫定/拉米夫定组（+4.0%）相比，二腺苷/司他夫定组（-16.8%）的肢体脂肪百分率变化更大
Objective: To determine if particular components of antiretroviral drug regimens are associated with greater insulin resistance, dyslipidemia, and peripheral lipoatrophy.Methods: Metabolic and body composition variables were measured prospectively over 64 weeks in 334 anti retroviral-naive, HIV-infected subjects who were randomized to receive nelfinavir, efavirenz, or both, combined with zidovudine/lamivudine or didanosine/stavudine in a factorial design, multicenter trial. Subjects assigned to efavirenz (n = 110) were compared with those assigned to nelfinavir (n = 99); subjects assigned to zidovudine/lamivudine (n = 154) were compared with those assigned to didanosine/stavudine (n = 180). A subset of 157 subjects had serial dual-energy X-ray absorptiometry (DEXA) scans.Results: Lipid measures increased in all groups. Greater increases in high density lipoprotein (HDL) cholesterol occurred with efavirenz than with nelfinavir. Greater increases in total cholesterol, non-HDL cholesterol and HDL cholesterol occurred with stavudine and didanosine than with zidovudine/lamivudine. There were no differences in insulin resistance in the comparisons. After initial increases in the first 16 weeks, median limb fat decreased. Greater changes in percentage changes in limb fat occurred with didanosine/stavudine (-16.8%) than with zidovudine/lamivudine (+4.0%; P