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Antropometry in HIV Patients: Effects of Recombinant Human Growth Hormone

  • Livio Luzi
  • Ileana Terruzzi
  • Stefano Benedini
Chapter

Abstract

Patients with HIV infection treated with protease inhibitors (PIs) drugs for a long period have a prolonged life expectancy and an improvement of quality of life. Often, HIV-patients on PIs develop a syndrome characterized by peripheral lipoatrophy, truncal fat accumulation, hyperlipemia and insulin resistance. In HIV-1 patients undergoing antiretroviral treatment, lipodystrophy is associated with peripheral fat wasting and central adiposity, dyslipidemia, insulin resistance, and increased intramuscular fat accumulation. In HIV lipodystrophy fat distribution changes are heterogeneous and can include reduced subcutaneous fat and increased visceral fat. In literature there are evidences showing overnight growth hormone (GH) secretion and pulse amplitude reduction in patients with HIV lipodystrophy, in response to standard GH stimulation test. Excess accumulation of visceral fat with increasing of intra-abdominal adiposity (central obesity) is also a typical feature of patients with GH deficiency. Recombinant human growth hormone (rhGH) can be a useful treatment to diminish excess visceral fat. Up to day there are evidences that GH therapy in HIV-infected patients with syndromes of central fat accumulation show a significant decrease of body fat. In this chapter, we discuss the anthropometry of lipodystrophy in HIV patients and the indication of rhGH treatment in HIV-related lipodystrophy.

Keywords

Growth Hormone Growth Hormone Deficiency Growth Hormone Treatment Growth Hormone Therapy Growth Hormone Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

Apo B

Apolipoprotein B

11ß-HSD1

11beta-hydroxysteroid dehydrogenase type 1

BMD

Bone mineral density

CT

Computer tomography

DEXA

Dual-energy x-ray absorptiometry

FFA

Free fatty acids

GC

Glucocorticoid

GH

Growth hormone

GHD

GH-deficient

GHBP

GH-binding protein

GHR

GH receptor

GHRH

Growth hormone releasing hormone

GLUT4

Glucose transporter 4

GR

Glucocorticoid receptor

Grb2

Growth receptor binding protein 2

HAART

Highly active antiretroviral therapy

HDL-C

High Density Lipoprotein-Cholesterol

HIV

Immunodeficiency virus

HMG CoA

3-Hydroxy-3-methylglutaryl coenzyme A

IDL

Intermediate density Lipoprotein

IGF-I

Insulin-like growth factor I

IGFBP-3

Insulin-like growth factor -binding protein 3

JAK

Janus Activated Kinase

Lp (a)

Lipoprotein (a)

LPL

Lipoprotein lipase

MAPK

Mitogen-activated protein kinase

MCP-1

Monocyte chemotactic protein-1

MRI

Magnetic resonance imaging

NRTIs

Nucleoside Reverse Transcriptase Inhibitors

PIs

Protease inhibitors (drugs)

Pl3K

Phosphatidylinositol 3-kinase

rhGH

Recombinant human growth hormone

Shc

Src (it is short form for sarcoma) homology domain containing

SOCS

Suppressor of cytokine signaling

SOS

Son of sevenless

STATs

Signal transducer and activator of transcription factors

TC

Total cholesterol

TG

Triglycerides

TNFα

Tumor necrosis factor-α

VLDL

Very Low Density Lipoprotein

Notes

Acknowledgments

This article has been reproduced with permission from Wolters Kluwer Health | Adis (see Benedini S, Terruzzi I, Lazzarin A, Luzi L. Recombinant human growth hormone: rationale for use in the treatment of HIV-associated lipodystrophy. BioDrugs. 2008;22(2):101–12.). © Adis Data Information BV 2008. All rights reserved.

References

  1. Benedini S, Dalle Carbonare, Albiger N, Scanarini M, Bilora F, Petrobelli F, Giannini S, Mantero F, Scaroni C. Horm Metab Res. 2006;38:16–21.PubMedCrossRefGoogle Scholar
  2. Benedini S, Terruzzi I, Lazzarin A, Luzi L. Recombinant human growth hormone: rationale for use in the treatment of HIV-associated lipodystrophy. BioDrugs. 2008;22:101–12.PubMedCrossRefGoogle Scholar
  3. Blethen SL, Allen DB, Graves D, August G, Moshang T, Rosenfeld R. J Clin Endocrinol Metab. 1996;81:1704–10.PubMedCrossRefGoogle Scholar
  4. Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, Cooper DA. AIDS. 1998;12:F51–8.PubMedCrossRefGoogle Scholar
  5. Carroll PV, Christ ER, Bengtsson B-Å, Carlsson L, Christiansen JS, Clemmons D, Hintz R, Ho K, Laron Z, Sizonenko P, Sönksen PH, Tanaka T, Thorner M. J Clin Endocrinol Metab. 1998;83:382–95.PubMedCrossRefGoogle Scholar
  6. Cofrancesco J Jr, Freedland E, McComsey G. AIDS Patient Care STDS. 2009;23:5–18.PubMedCrossRefGoogle Scholar
  7. Cutfield WS, Wilton P, Bennmarker H, Albertsson-Wikland K, Chatelain P, Ranke MB, Price DA. Lancet. 2000;19(355):610–3.CrossRefGoogle Scholar
  8. Esposito GJ, Thomas SG, Kingdon L, Ezzat S. J Clin Endocrinol Metab. 2006;91:2952–9.PubMedCrossRefGoogle Scholar
  9. Filipsson H, Monson JP, Koltowska-Häggström M, Mattsson A, Johannsson G. J Clin Endocrinol Metab. 2006;91:3954–61.PubMedCrossRefGoogle Scholar
  10. Grinspoon S. Nat Clin Pract Endocrinol Metab. 2006;2:355.PubMedCrossRefGoogle Scholar
  11. Haugaard SB, Andersen O, Flyvbjergd A, Ørskovd H, Madsbad S, Iversen J. J Infect. 2006;52:389–98.PubMedCrossRefGoogle Scholar
  12. Haugaard SB, Andersen O, Pedersen SB, Dela F, Fenger M, Richelsen B, Madsbad S, Iversen J. Metabolism. 2006;55:175–82.PubMedCrossRefGoogle Scholar
  13. He Q, Engelson ES, Albu JB, Heymsfield SB, Kotler DP. J Appl Physiol. 2003;94:2051–7.PubMedGoogle Scholar
  14. Ho KK, O’Sullivan AJ, Hoffman DM. Endocr J. 1996;43:57–63.Google Scholar
  15. Hoffmann C, Rockstroh JK, Kamps BS. In: Steinhäuser Verlag, editor. HIV medicine. Cologne; 2005. p. 283–98.Google Scholar
  16. Hruz PW. Am J Infect Dis. 2006;2:187–92.PubMedCrossRefGoogle Scholar
  17. Jenkins PJ, Bustin SA. Eur J Endocrinol. 2004;151(Suppl 1):S17–22.PubMedCrossRefGoogle Scholar
  18. Johansson JO, Fowelin J, Landin K, Lager I, Bengtsson BA. Metab Clin Exp. 1995;44:1126–9.PubMedCrossRefGoogle Scholar
  19. Kotler DP, Muurahainen N, Grunfeld C, Wanke C, Thompson M, Saag MM, Bock D, Simons G, Gertner JM. J Acquir Immune Defic Syndr. 2004;1(35):239–52.PubMedCrossRefGoogle Scholar
  20. Koutkia P, Canavan B, Breu J, Grinspoon S. J Clin Endocrinol Metab. 2005;90:32–8.PubMedCrossRefGoogle Scholar
  21. Kravcik S. HIV Clin Trials. 2000;1:37–50.PubMedCrossRefGoogle Scholar
  22. Luzi L, Meneghini E, Oggionni S, Tambussi G, Piceni-Sereni L, Lazzarin A. Eur J Endocrinol. 2005;153:781–9.PubMedCrossRefGoogle Scholar
  23. Luzi L, Perseghin G, Tambussi G, Meneghini E, Scifo P, Pagliato E, Del Maschio A, Testolin G, Lazzarin A. Am J Physiol Endocrinol Metab. 2003;284:E274–80.PubMedGoogle Scholar
  24. Mauras N, O’Brien KO, Welch S, Rini A, Helgeson K, Vieira NE, Yergey AL. J Clin Endocrinol Metab. 2000;85:1686–94.PubMedCrossRefGoogle Scholar
  25. Monson JP. Eur J Endocrinol. 2003;148(Suppl 2):S9–14.PubMedCrossRefGoogle Scholar
  26. Mukherjee A, Attanasio AF, Shalet SM. Growth Horm IGF Res.2003; 13(Suppl A):S130–5.PubMedCrossRefGoogle Scholar
  27. Saint-Marc T, Touraine JL. AIDS. 1999;28;13(8):1000–2.PubMedCrossRefGoogle Scholar
  28. Shadid S, Jensen MD. Obes Res. 2003;11:170–5.PubMedCrossRefGoogle Scholar
  29. Svensson J, Fowelin J, Landin K, Bengtsson BA, Johansson JO. J Clin Endocrinol Metab. 2002;87:2121–7.PubMedCrossRefGoogle Scholar
  30. Thomas SG, Esposito JG, Ezzat S. J Clin Endocrinol Metab. 2003;88:5734–8.PubMedCrossRefGoogle Scholar
  31. Tomlinson JW, Crabtree N, Clark PM, Holder G, Toogood, AA Shackleton CH, Stewart PM. J Clin Endocrinol Metab. 2003;88:2113–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Head Metabolism Research CentreIRCCS Policlinico San Donato MilaneseMilanItaly
  2. 2.Department of Sport Sciences, Nutrition and Health, Faculty of Exercise SciencesUniversity of MilanMilanItaly

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