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Insulin Resistance and HIV-Related Lipoatrophy
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To the Editor: Dr Carr and colleagues1 found that abacavir was associated with a modest increase in limb fat among adults with human immunodeficiency virus (HIV)–related lipoatrophy. However, there was a wide variation in baseline levels of fasting plasma insulin and triglycerides among the subjects, as reflected by the large SDs that were almost equal to and sometimes exceeded the corresponding means. There was less variation in the baseline anthropometric parameters, which does not fully explain such wide variation in insulin and triglyceride measures. On the other hand, mean levels of fasting plasma glucose were within the normal range, and associated with small SDs.
There are 2 possibilities, which are not mutually exclusive, that may explain these findings. First, as expected in HIV lipoatrophy, some patients could have insulin resistance, characterized by hypertriglyceridemia and compensatory hyperinsulinemia.2 The inclusion of such patients could have widened the range of levels of plasma . . . [Full Text of this Article]
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