The
lipodystrophy syndrome (adipose tissue redistribution and metabolic abnormalities) observed with
highly active antiretroviral therapy (
HAART) during human immunodeficiency virus (
HIV) infection may be related to increased proinflammatory
cytokine activity. We measured acute
cytokine (TNF-alpha, IL-6, leptin),
glycerol, and
lactate secretion from abdominal subcutaneous adipose tissue (SAT), and systemic
cytokine levels, in HIV-infected subjects with and without
lipodystrophy (HIVL+ and HIVL-, respectively) and healthy non-HIV controls.
Lipodystrophy was confirmed and characterized as adipose tissue redistribution in HIVL+ compared with HIVL- and controls, by dual-energy X-ray absorptiometry and by whole body MRI.
TNF-alpha secretion from abdominal SAT and circulating levels of
IL-6, soluble
TNF receptors I and II, and
insulin were elevated in HIVL+ relative to HIVL- and/or controls, particularly in HIVL+ undergoing
HAART. In the HIV-infected group as a whole,
IL-6 secretion from abdominal SAT and serum
IL-6 were positively associated with visceral fat and were negatively associated with the relative amount of lower limb adipose tissue (P < 0.01). Decreased
leptin and increased
lactate secretion from abdominal SAT were specifically associated with
HAART. In conclusion, increased
cytokine secretion from adipose tissue and increased systemic proinflammatory
cytokine activity may play a significant role in the adipose tissue remodeling and/or the metabolic abnormalities associated with the
HIV-lipodystrophy syndrome in patients undergoing
HAART.