HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management
HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management
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DOI：
10.1097/00002030-200304001-00017
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发表时间：
2003-04-01
期刊：
影响因子：
3.8
通讯作者：
Carr, A
中科院分区：
文献类型：
--
作者：
Carr, A
HIV脂肪营养不良是一种异质性综合征，其尚未被客观地定义，包括外周脂肪萎缩、中心脂肪堆积和脂肪瘤，以及沿着脂肪血症、胰岛素抵抗和乳酸血症。核苷类似物和蛋白酶抑制剂都参与其中，但也有宿主因素可能使一些患者面临更大的风险。发病机制越来越多地被理解，有证据表明几种调节蛋白如固醇调节增强子结合蛋白-1、蛋白酶体、线粒体DNA聚合酶γ和GLUT-4的干扰。沿着美容和污名化的问题，脂肪代谢障碍引起的主要临床问题是加速动脉粥样硬化的风险可能增加。各种旨在限制这些风险的治疗干预措施正在评估中，但没有一种最终显示出价值。(C)2003年利平科特威廉姆斯威尔金斯。
HIV lipodystrophy is a heterogeneous syndrome, which has yet to be objectively defined, comprising peripheral lipoatrophy, central fat accumulation and lipomata, along with hyperlipidaemia, insulin resistance and lactic acidaemia. Both nucleoside analogues and protease inhibitors are involved, but there are also host factors that probably place some patients at greater risk. The pathogenesis is increasingly understood, with evidence of interference of several regulatory proteins such as sterol regulatory enhancer binding protein-1, the proteasome, mitochondrial DNA polymerase gamma and GLUT-4. Along with the issues of cosmesis and stigmatization, a principal clinical concern that arises with lipodystrophy is a possible increased risk of accelerated atherosclerosis. A variety of therapeutic interventions, designed to limit these risks, are under evaluation, but none is conclusively shown to be of value. (C) 2003 Lippincott Williams Wilkins.