Insulin resistance and lipid profiles in HIV-infected Thai children receiving lopinavir/ritonavir-based highly active antiretroviral therapy

J Pediatr Endocrinol Metab. 2014 May;27(5-6):403-12. doi: 10.1515/jpem-2013-0253.

Abstract

Background: Lopinavir/ritonavir (LPV/r) is associated with insulin resistance (IR). We aim to determine the prevalence of IR, dyslipidemia and their inter-relationships with adipokines in HIV-infected children treated with LPV/r-based highly active antiretroviral therapy (HAART).

Methods: Twenty-eight children were enrolled. Fasting glucose, insulin, lipid profiles, adipokines, and oral glucose tolerance tests were performed.

Results: The prevalence of IR, pre-diabetes mellitus, and hypertriglyceridemia was 42.9(12/28), 10.7(3/28), and 75.0(21/28)% respectively. No case met the definition for diabetes mellitus (DM) and lipodystrophy. Children with IR had higher BMI z-score, triglyceride levels but unchanged leptin or adiponectin levels compared to those without IR. Longer duration of LPV/r-based HAART was associated with increased levels of triglyceride and total cholesterol.

Conclusions: We describe high prevalence of IR, pre-diabetes mellitus, and dyslipidemia among HIV-infected children receiving LPV/r-based HAART. Pre-diabetes mellitus or DM or IR screening might be important for early diagnosis and intervention in these children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines / blood
  • Adolescent
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • Blood Glucose / metabolism
  • Child
  • Child, Preschool
  • Dyslipidemias / chemically induced
  • Dyslipidemias / epidemiology
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy
  • HIV Infections / metabolism*
  • Humans
  • Insulin Resistance / physiology*
  • Lipids / blood*
  • Lopinavir / adverse effects*
  • Lopinavir / therapeutic use
  • Male
  • Pregnancy
  • Ritonavir / adverse effects*
  • Ritonavir / therapeutic use
  • Thailand

Substances

  • Adipokines
  • Anti-HIV Agents
  • Blood Glucose
  • Lipids
  • Lopinavir
  • Ritonavir