Altered phosphate metabolism in HIV-1-infected patients: another feature of metabolic syndrome?
© Grima et al; licensee BioMed Central Ltd. 2010
Published: 8 November 2010
Purpose of the study
Metabolic syndrome represent a cluster of cardiovascular risk factors that has become a serious problem for HIV-1-infected patients. It was proposed that disturbances in phosphate metabolism may represent a key feature of metabolic syndrome. Because phosphate is involved directly in carbohydrate metabolism, hypophosphatemia can results in impaired utilization of glucose, insulin resistance and hyperinsulinemia. Thus, we undertook the present study to investigate the relationship between phosphate levels and the presence of the characteristics of metabolic syndrome, as well as the mechanism that may be responsible for reduced phosphate levels in patients with this syndrome.
130 HIV-1-infected patients were consecutively enrolled in a prospective, cross-sectional, single centre study. All patients were receiving HAART for more than six months. We selected two groups: HIV+ patients with metabolic syndrome (group A, n=86) and HIV+ patients without metabolic syndrome (group B, n=44). The diagnosis of metabolic syndrome was based on Adult Treatment Panel III guidelines. Demographic characteristics, metabolic variables, duration of Tenofovir therapy, duration of HAART, CD4 and viral load were collected. Kidney tubular function was examined using tubular resorption of phosphate and normalized renal threshold phosphate concentration.
Summary of results
Our preliminary data demonstrated that HIV-1-infected patients with metabolic syndrome showed significantly lower phosphate levels compared with HIV-1-infected patients without metabolic syndrome regardless of tenofovir based therapy. The clinical significance of these disturbances, as well as their importance as target for preventive or therapeutic interventions, remains to be established.
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