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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Long-term body composition and metabolic changes in antiretroviral naive persons randomized to protease inhibitor-, nonnucleoside reverse transcriptase inhibitor-, or protease inhibitor plus nonnucleoside reverse transcriptase inhibitor-based strateg
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Long-term body composition and metabolic changes in antiretroviral naive persons randomized to protease inhibitor-, nonnucleoside reverse transcriptase inhibitor-, or protease inhibitor plus nonnucleoside reverse transcriptase inhibitor-based strateg

机译：随机分为蛋白酶抑制剂，非核苷逆转录酶抑制剂或蛋白酶抑制剂加非核苷逆转录酶抑制剂为基础的抗逆转录病毒天真的人的长期身体组成和代谢变化

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OBJECTIVE: To assess changes in metabolic parameters and body composition among 422 antiretroviral-naive patients randomized to 3 antiretroviral therapy (ART) strategies: protease inhibitor (PI; n = 141)-, nonnucleoside reverse transcriptase inhibitor (NNRTI; n = 141)-, or PI + NNRTI (n = 140)-based strategies with a median follow-up of 5 years. METHODS: At baseline and 1-month (metabolic parameters only) and 4-month follow-up intervals, fat-free mass (FFM) and total body fat were calculated, anthropometric measurements were performed, and fasting metabolic parameters were obtained. Rates of change and mean change were compared. RESULTS: The PI + NNRTI strategy resulted in greater increases in triglycerides and low-density lipoprotein cholesterol compared with the PI and the NNRTI strategies (P < 0.005), with no differences between the PI and NNRTI strategies. High-density lipoprotein cholesterol increased significantly more in the NNRTI strategy than in the PI strategy (P < 0.005). Insulin and insulinresistance increased similarly with all 3 strategies. Changes in total and regional body composition (loss of subcutaneous tissue area and gains in FFM, nonsubcutaneous tissue area, and visceral tissue area) were observed but did not differ by strategy. CONCLUSIONS: Long-term follow-up of participants initiating 3 ART strategies demonstrated similar changes in total and regional fat, with no differences by ART strategy. The differential effects on lipid metabolism by strategy and the overall increases in insulin and insulin resistance with all 3 strategies necessitate close monitoring of patients on ART.
机译：目的：评估随机分配给3种抗逆转录病毒治疗（ART）策略的422例初次接受抗逆转录病毒治疗的患者的代谢参数和身体组成的变化：蛋白酶抑制剂（PI; n = 141）-，非核苷逆转录酶抑制剂（NNRTI; n = 141）- ，或基于PI + NNRTI（n = 140）的策略，平均随访5年。方法：在基线和1个月（仅代谢参数）和4个月的随访间隔内，计算无脂肪质量（FFM）和体内总脂肪，进行人体测量，并获得空腹代谢参数。比较变化率和均值变化。结果：与PI和NNRTI策略相比，PI + NNRTI策略导致甘油三酸酯和低密度脂蛋白胆固醇的增加更大（P <0.005），而PI和NNRTI策略之间没有差异。高密度脂蛋白胆固醇在NNRTI策略中比在PI策略中显着增加（P <0.005）。胰岛素和胰岛素抵抗在所有三种策略中均类似地增加。观察到总体和区域身体组成的变化（皮下组织面积的损失和FFM，非皮下组织面积和内脏组织面积的增加），但在策略上没有差异。结论：参与者的长期随访开始了3种抗逆转录病毒治疗策略，表明总脂肪和局部脂肪的变化相似，而抗逆转录病毒治疗策略无差异。不同策略对脂质代谢的不同影响以及胰岛素和胰岛素抵抗的总体增加，所有这三种策略都需要对ART患者进行密切监测。

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