Evaluation of glucose uptake by skeletal muscle tissue and subcutaneous fat in HIV-infected patients with and without lipodystrophy using FDG-PET
Nuclear Medicine Communications
Department of Nuclear Medicine, Pretoria Academic Hospital, University of Pretoria, Private Bag X169, Pretoria 0001, South Africa; Department of Infectious Diseases, University of Pretoria, Pretoria, South Africa; Department of Internal Medicine, Louis Pasteur Hospital, Pretoria, South Africa; Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Morphology and Medical Imaging, University Hospital Leuven, Leuven, Belgium; Department of Nuclear Medicine, University Hospital Ghent, Ghent, Belgium
Objective: To evaluate differences in glucose uptake by skeletal muscle tissue and subcutaneous fat in HIV patients on highly active antiretroviral therapy (HAART) presenting with and without lipodystrophy as well as in drug-naive HIV patients using 18F-fluorodeoxyglucose (FDG) positron emission tomography. Patients and methods: Thirty-nine consecutive patients suffering from HIV: seven drug-naive patients, 21 nonlipodystrophic patients on HAART and 11 patients on HAART, respectively, suffering from lipodystrophy were prospectively included. All patients underwent a whole-body FDG positron emission tomography examination. Standardized uptake values (SUV values) of muscle and subcutaneous fat were compared and related to demographic and biochemical variables. Results: SUV mean values of subcutaneous fat were significantly higher in patients under HAART presenting with lipodystrophy when compared with untreated and treated, nonlipodystrophic patients (P=0.000). SUV mean values of subcutaneous fat significantly correlated with treatment duration (r =0.56, P=0.000) and CD4 count (r=0.51, P= 0.001) and inversely correlated with viral load (r = -0.61, P=0.000). Finally, SUV mean values of thigh muscles were not significantly different between the three different patient groups under study. Conclusion: Quantitative FDG uptake by subcutaneous fat proved significantly higher in HIV patients under HAART presenting with lipodystrophy. HAART did not influence FDG uptake by human skeletal muscle tissue under basal conditions. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
didanosine; efavirenz; fluorodeoxyglucose f 18; lamivudine; nevirapine; stavudine; anti human immunodeficiency virus agent; diagnostic agent; fluorodeoxyglucose f 18; glucose; adult; article; clinical article; controlled study; glucose transport; highly active antiretroviral therapy; HIV associated lipodystrophy; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; patient monitoring; positron emission tomography; quantitative diagnosis; skeletal muscle; subcutaneous fat; virus load; adolescent; clinical trial; comparative study; cytology; drug effect; female; highly active antiretroviral therapy; Human immunodeficiency virus infection; insulin resistance; lipodystrophy; male; metabolism; middle aged; positron emission tomography; scintiscanning; skeletal muscle; subcutaneous fat; transport at the cellular level; treatment outcome; Adolescent; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Biological Transport; Female; Fluorodeoxyglucose F18; Glucose; HIV Infections; Humans; Insulin Resistance; Lipodystrophy; Male; Middle Aged; Muscle, Skeletal; Positron-Emission Tomography; Subcutaneous Fat; Treatment Outcome; Young Adult