Cargando…

Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study

BACKGROUND: HIV-infected patients starting antiretroviral treatment (ART) experience deep and early disorders in fat and bone metabolism, leading to concomitant changes in fat mass and bone mineral density. METHODS: We conducted a prospective study in treatment-naive HIV-infected patients randomized...

Descripción completa

Detalles Bibliográficos
Autores principales: Bonnet, Eric, Ruidavets, Jean-Bernard, Genoux, Anne, Mabile, Laurence, Busato, Florian, Obadia, Martine, Prévoteau, François, Marchou, Bruno, Massip, Patrice, Marion-Latard, Fabrice, Delpierre, Cyrille, Bernard, Jacques, Perret, Bertrand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707772/
https://www.ncbi.nlm.nih.gov/pubmed/23809140
http://dx.doi.org/10.1186/1471-2334-13-293
_version_ 1782276532361756672
author Bonnet, Eric
Ruidavets, Jean-Bernard
Genoux, Anne
Mabile, Laurence
Busato, Florian
Obadia, Martine
Prévoteau, François
Marchou, Bruno
Massip, Patrice
Marion-Latard, Fabrice
Delpierre, Cyrille
Bernard, Jacques
Perret, Bertrand
author_facet Bonnet, Eric
Ruidavets, Jean-Bernard
Genoux, Anne
Mabile, Laurence
Busato, Florian
Obadia, Martine
Prévoteau, François
Marchou, Bruno
Massip, Patrice
Marion-Latard, Fabrice
Delpierre, Cyrille
Bernard, Jacques
Perret, Bertrand
author_sort Bonnet, Eric
collection PubMed
description BACKGROUND: HIV-infected patients starting antiretroviral treatment (ART) experience deep and early disorders in fat and bone metabolism, leading to concomitant changes in fat mass and bone mineral density. METHODS: We conducted a prospective study in treatment-naive HIV-infected patients randomized to receive two nucleoside reverse transcriptase inhibitors in combination with either a protease inhibitor (PI) or a non-nucleosidic reverse transcriptase inhibitor (NNRTI), to evaluate early changes in body composition, bone mineral density and metabolic markers as differentially induced by antiretroviral therapies. We measured changes in markers of carbohydrate, of fat and bone metabolism, and, using dual-emission X-ray absorptiometry (DXA), body composition and bone mineral density (BMD). Complete data on changes between baseline and after 21 months treatment were available for 35 patients (16 in the PI group and 19 in the NNRTI group). RESULTS: A significant gain in BMI and in total and lower limb fat mass was recorded only in patients receiving PI. A loss of lumbar BMD was observed in both groups, being higher with PI. Plasma markers of bone metabolism (alkaline phosphatase, osteocalcin, collagen crosslaps) and levels of parathormone and of 1,25diOH-vitamin D3 significantly increased in both groups, concomitant with a decline in 25OH-vitamin D3. Lipids and glucose levels increased in both groups but rise in triglyceride was more pronounced with PI. A correlation between loss of BMD and gain of fat mass is observed in patients starting PI. CONCLUSIONS: We evidenced an early effect of ART on lipid and bone metabolisms. PI lead to a significant gain in fat mass correlated with a sharp drop in BMD but active bone remodelling is evident with all antiretroviral treatments, associated with low vitamin D levels and hyperparathyroidism. In parallel, signs of metabolic restoration are evident. However, early increases in lean and fat mass, triglycerides, waist circumference and leptin are much more pronounced with PI.
format Online
Article
Text
id pubmed-3707772
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-37077722013-07-11 Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study Bonnet, Eric Ruidavets, Jean-Bernard Genoux, Anne Mabile, Laurence Busato, Florian Obadia, Martine Prévoteau, François Marchou, Bruno Massip, Patrice Marion-Latard, Fabrice Delpierre, Cyrille Bernard, Jacques Perret, Bertrand BMC Infect Dis Research Article BACKGROUND: HIV-infected patients starting antiretroviral treatment (ART) experience deep and early disorders in fat and bone metabolism, leading to concomitant changes in fat mass and bone mineral density. METHODS: We conducted a prospective study in treatment-naive HIV-infected patients randomized to receive two nucleoside reverse transcriptase inhibitors in combination with either a protease inhibitor (PI) or a non-nucleosidic reverse transcriptase inhibitor (NNRTI), to evaluate early changes in body composition, bone mineral density and metabolic markers as differentially induced by antiretroviral therapies. We measured changes in markers of carbohydrate, of fat and bone metabolism, and, using dual-emission X-ray absorptiometry (DXA), body composition and bone mineral density (BMD). Complete data on changes between baseline and after 21 months treatment were available for 35 patients (16 in the PI group and 19 in the NNRTI group). RESULTS: A significant gain in BMI and in total and lower limb fat mass was recorded only in patients receiving PI. A loss of lumbar BMD was observed in both groups, being higher with PI. Plasma markers of bone metabolism (alkaline phosphatase, osteocalcin, collagen crosslaps) and levels of parathormone and of 1,25diOH-vitamin D3 significantly increased in both groups, concomitant with a decline in 25OH-vitamin D3. Lipids and glucose levels increased in both groups but rise in triglyceride was more pronounced with PI. A correlation between loss of BMD and gain of fat mass is observed in patients starting PI. CONCLUSIONS: We evidenced an early effect of ART on lipid and bone metabolisms. PI lead to a significant gain in fat mass correlated with a sharp drop in BMD but active bone remodelling is evident with all antiretroviral treatments, associated with low vitamin D levels and hyperparathyroidism. In parallel, signs of metabolic restoration are evident. However, early increases in lean and fat mass, triglycerides, waist circumference and leptin are much more pronounced with PI. BioMed Central 2013-06-28 /pmc/articles/PMC3707772/ /pubmed/23809140 http://dx.doi.org/10.1186/1471-2334-13-293 Text en Copyright © 2013 Bonnet et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bonnet, Eric
Ruidavets, Jean-Bernard
Genoux, Anne
Mabile, Laurence
Busato, Florian
Obadia, Martine
Prévoteau, François
Marchou, Bruno
Massip, Patrice
Marion-Latard, Fabrice
Delpierre, Cyrille
Bernard, Jacques
Perret, Bertrand
Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title_full Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title_fullStr Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title_full_unstemmed Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title_short Early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective Lipotrip study
title_sort early loss of bone mineral density is correlated with a gain of fat mass in patients starting a protease inhibitor containing regimen: the prospective lipotrip study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707772/
https://www.ncbi.nlm.nih.gov/pubmed/23809140
http://dx.doi.org/10.1186/1471-2334-13-293
work_keys_str_mv AT bonneteric earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT ruidavetsjeanbernard earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT genouxanne earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT mabilelaurence earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT busatoflorian earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT obadiamartine earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT prevoteaufrancois earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT marchoubruno earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT massippatrice earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT marionlatardfabrice earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT delpierrecyrille earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT bernardjacques earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy
AT perretbertrand earlylossofbonemineraldensityiscorrelatedwithagainoffatmassinpatientsstartingaproteaseinhibitorcontainingregimentheprospectivelipotripstudy