Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy

Asha Thomas-Geevarghese, Subhashree Raghavan, Robert Minolfo, Steve Holleran, Rajasekhar Ramakrishnan, Bernard Ormsby, Wahida Karmally, Henry N. Ginsberg, Wafaa M. El-Sadr, Jeanine Albu, Lars Berglund

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Features of the dyslipidemic pattern reported with the use of antiretroviral therapy predict enhanced postprandial lipemia, which is an emerging cardiovascular disease risk factor. Objective: We evaluated the postprandial response to a physiologic, meal-based challenge in HIV-positive subjects without hyperlipidemia. Design: We measured hourly lipid, lipoprotein, glucose, and insulin concentrations during a 13-h period in 25 non white patients (13 women, 12 men): 13 receiving a protease inhibitor (PI)-based regimen (6 nelfinavir and 7 indinavir) and 12 receiving a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen (6 efavirenz and 6 nevirapine). Results: Mean fasting HDL-cholesterol concentrations were lower in HIV patients than in healthy subjects without HIV infection matched for age, sex, and ethnicity (z score: -0.81 ± 0.9; P = 0.0001). Fasting triacylglycerol concentrations were not significantly different between HIV-infected patients and healthy subjects but were higher in Pi-treated than in NNRTI-treated patients [median (interquartile range): 144 (110-191) and 89 (62-135) mg/dL; P = 0.007]. Average daylong triacylglycerol concentrations, but not incremental concentrations, were higher in the PI group than in the NNRTI group [205% (185-248%) and 125% (78-191%); P < 0.05]. For all HIV-positive patients, the fractional triacylglycerol increase was lower after breakfast than after lunch (20 ± 18% and 42 ± 40%, respectively; P < 0.04). Insulin concentrations were higher in PI-treated than in NNRTI-treated patients [22.6 (13.1-29.8) and 11.8 (7.1-19.1) μU/mL; P = 0.01] and increased in both groups in response to each meal, whereas glucose concentrations increased only after breakfast. Conclusions: Despite baseline differences, incremental triacylglycerol and insulin responses to a physiologic caloric load among HIV-positive patients were not significantly affected by differences in the type of antiretroviral therapy.

Original languageEnglish (US)
Pages (from-to)146-154
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume82
Issue number1
StatePublished - 2005

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Reverse Transcriptase Inhibitors
RNA-directed DNA polymerase
proteinase inhibitors
Protease Inhibitors
HIV
therapeutics
Triglycerides
triacylglycerols
insulin
Breakfast
breakfast
efavirenz
hyperlipidemia
Insulin
meals (menu)
Hyperlipidemias
Therapeutics
fasting
Meals
Fasting

Keywords

  • African Americans
  • Antiretroviral treatment
  • ART
  • HIV
  • Insulin resistance
  • NNRTI
  • Nonnucleoside reverse transcriptase inhibitor
  • Postprandial lipemia
  • Protease inhibitors

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy. / Thomas-Geevarghese, Asha; Raghavan, Subhashree; Minolfo, Robert; Holleran, Steve; Ramakrishnan, Rajasekhar; Ormsby, Bernard; Karmally, Wahida; Ginsberg, Henry N.; El-Sadr, Wafaa M.; Albu, Jeanine; Berglund, Lars.

In: American Journal of Clinical Nutrition, Vol. 82, No. 1, 2005, p. 146-154.

Research output: Contribution to journalArticle

Thomas-Geevarghese, A, Raghavan, S, Minolfo, R, Holleran, S, Ramakrishnan, R, Ormsby, B, Karmally, W, Ginsberg, HN, El-Sadr, WM, Albu, J & Berglund, L 2005, 'Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy', American Journal of Clinical Nutrition, vol. 82, no. 1, pp. 146-154.
Thomas-Geevarghese, Asha ; Raghavan, Subhashree ; Minolfo, Robert ; Holleran, Steve ; Ramakrishnan, Rajasekhar ; Ormsby, Bernard ; Karmally, Wahida ; Ginsberg, Henry N. ; El-Sadr, Wafaa M. ; Albu, Jeanine ; Berglund, Lars. / Postprandial response to a physiologic caloric load in HIV-positive patients receiving protease inhibitor-based or nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy. In: American Journal of Clinical Nutrition. 2005 ; Vol. 82, No. 1. pp. 146-154.
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abstract = "Background: Features of the dyslipidemic pattern reported with the use of antiretroviral therapy predict enhanced postprandial lipemia, which is an emerging cardiovascular disease risk factor. Objective: We evaluated the postprandial response to a physiologic, meal-based challenge in HIV-positive subjects without hyperlipidemia. Design: We measured hourly lipid, lipoprotein, glucose, and insulin concentrations during a 13-h period in 25 non white patients (13 women, 12 men): 13 receiving a protease inhibitor (PI)-based regimen (6 nelfinavir and 7 indinavir) and 12 receiving a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen (6 efavirenz and 6 nevirapine). Results: Mean fasting HDL-cholesterol concentrations were lower in HIV patients than in healthy subjects without HIV infection matched for age, sex, and ethnicity (z score: -0.81 ± 0.9; P = 0.0001). Fasting triacylglycerol concentrations were not significantly different between HIV-infected patients and healthy subjects but were higher in Pi-treated than in NNRTI-treated patients [median (interquartile range): 144 (110-191) and 89 (62-135) mg/dL; P = 0.007]. Average daylong triacylglycerol concentrations, but not incremental concentrations, were higher in the PI group than in the NNRTI group [205{\%} (185-248{\%}) and 125{\%} (78-191{\%}); P < 0.05]. For all HIV-positive patients, the fractional triacylglycerol increase was lower after breakfast than after lunch (20 ± 18{\%} and 42 ± 40{\%}, respectively; P < 0.04). Insulin concentrations were higher in PI-treated than in NNRTI-treated patients [22.6 (13.1-29.8) and 11.8 (7.1-19.1) μU/mL; P = 0.01] and increased in both groups in response to each meal, whereas glucose concentrations increased only after breakfast. Conclusions: Despite baseline differences, incremental triacylglycerol and insulin responses to a physiologic caloric load among HIV-positive patients were not significantly affected by differences in the type of antiretroviral therapy.",
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AU - Raghavan, Subhashree

AU - Minolfo, Robert

AU - Holleran, Steve

AU - Ramakrishnan, Rajasekhar

AU - Ormsby, Bernard

AU - Karmally, Wahida

AU - Ginsberg, Henry N.

AU - El-Sadr, Wafaa M.

AU - Albu, Jeanine

AU - Berglund, Lars

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N2 - Background: Features of the dyslipidemic pattern reported with the use of antiretroviral therapy predict enhanced postprandial lipemia, which is an emerging cardiovascular disease risk factor. Objective: We evaluated the postprandial response to a physiologic, meal-based challenge in HIV-positive subjects without hyperlipidemia. Design: We measured hourly lipid, lipoprotein, glucose, and insulin concentrations during a 13-h period in 25 non white patients (13 women, 12 men): 13 receiving a protease inhibitor (PI)-based regimen (6 nelfinavir and 7 indinavir) and 12 receiving a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen (6 efavirenz and 6 nevirapine). Results: Mean fasting HDL-cholesterol concentrations were lower in HIV patients than in healthy subjects without HIV infection matched for age, sex, and ethnicity (z score: -0.81 ± 0.9; P = 0.0001). Fasting triacylglycerol concentrations were not significantly different between HIV-infected patients and healthy subjects but were higher in Pi-treated than in NNRTI-treated patients [median (interquartile range): 144 (110-191) and 89 (62-135) mg/dL; P = 0.007]. Average daylong triacylglycerol concentrations, but not incremental concentrations, were higher in the PI group than in the NNRTI group [205% (185-248%) and 125% (78-191%); P < 0.05]. For all HIV-positive patients, the fractional triacylglycerol increase was lower after breakfast than after lunch (20 ± 18% and 42 ± 40%, respectively; P < 0.04). Insulin concentrations were higher in PI-treated than in NNRTI-treated patients [22.6 (13.1-29.8) and 11.8 (7.1-19.1) μU/mL; P = 0.01] and increased in both groups in response to each meal, whereas glucose concentrations increased only after breakfast. Conclusions: Despite baseline differences, incremental triacylglycerol and insulin responses to a physiologic caloric load among HIV-positive patients were not significantly affected by differences in the type of antiretroviral therapy.

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