Horm Metab Res 2009; 41(7): 573-579
DOI: 10.1055/s-0029-1202779
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

The Effect of Rosiglitazone on Insulin Sensitivity, Beta Cell Function, Bone Mineral Density, and Body Composition in HIV-positive Patients on Highly-active Antiretroviral Therapy (HAART)

K. Schindler 1 , A. Rieger 2 , A. Tura 3 , B. Gmeinhardt 2 , V. Touzeau-Römer 2 , D. Haider 1 , G. Pacini 3 , B. Ludvik 1
  • 1Department of Medicine 3, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria
  • 2Department of Dermatology, Medical University of Vienna, Austria
  • 3Metabolic Unit, Institute of Biomedical Engineering (ISIB), National Research Council (CNR), Padova, Italy
Further Information

Publication History

received 16.07.2008

accepted 15.01.2009

Publication Date:
25 March 2009 (eFirst)

Abstract

Highly active antiretroviral therapy (HAART) leads to lipodystrophy and is associated with detrimental changes in glucose and lipid metabolism. This study investigated the impact of rosiglitazone on insulin sensitivity, beta cell function, bone mineral density, and body composition in HIV+ nondiabetic subjects under HAART. In this randomized, double blind, placebo controlled parallel group study, 40 HIV+ subjects were treated with rosiglitazone 4 mg/day (R, n=23) or placebo (P, n=17) for 6 months. Glucose, insulin and C peptide concentrations were analyzed for assessing insulin sensitivity and secretion. Adiponectin and leptin were evaluated. Body fluid compartments were measured with bioelectrical impedance spectroscopy, and bone mineral density and body composition with Dual X Ray absorptiometry. Rosiglitazone improved peripheral insulin sensitivity (+36.7±15.7 ml/min/m2, p=0.03, means±SEM), while no change was observed in P (+4.5±19.5 ml/min/m2, p=0.55). Liver insulin resistance, beta cell activity, and hepatic insulin clearance did not change. Plasma adiponectin increased (R: +2.47±0.86 μg/ml, p=0.01 vs. P: +0.45±0.60, p=0.28). Rosiglitazone had no influence on body composition, fat distribution and bone mineral density but expanded extra-cellular fluid volume in HIV infected persons (R: +0.50±0.21 l, p=0.02 vs. P: 0.10±0.25 l, p=0.32). Lipid metabolism in P remained unchanged, in R total cholesterol and LDL cholesterol levels increased significantly (p<0.05). Rosiglitazone treatment resulted in improved peripheral insulin sensitivity with increased circulating adiponectin in HIV patients under HAART. No effect was seen on body fat distribution, bone mineral density, and weight. These side effects and their potential for cardiac risk must be weighed against the beneficial effects on glucose metabolism.

References

Correspondence

B. Ludvik, MD 

Department of Medicine 3

Medical University of Vienna

Waehringer Guertel 18-20

1090 Vienna

Austria

Phone: +43/140/40 04 364

Fax: +43/140/40 04 364

Email: bernhard.ludvik@meduniwien.ac.at