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Tadesse BT, Foster BA, Chala A, Chaka TE, Bizuayehu T, Ayalew F, H/Meskel G, Tadesse S, Jerene D, Makonnen E, Aklillu E. HIV and cART-Associated Dyslipidemia Among HIV-Infected Children. J Clin Med 2019; 8:jcm8040430. [PMID: 30925831 PMCID: PMC6518233 DOI: 10.3390/jcm8040430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/15/2019] [Accepted: 03/26/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Persistent dyslipidemia in children is associated with risks of cardiovascular accidents and poor combination antiretroviral therapy (cART) outcome. We report on the first evaluation of prevalence and associations with dyslipidemia due to HIV and cART among HIV-infected Ethiopian children. METHODS 105 cART naïve and 215 treatment experienced HIV-infected children were enrolled from nine HIV centers. Demographic and clinical data, lipid profile, cART type, adherence to and duration on cART were recorded. Total, low density (LDLc) and high density (HDLc) cholesterol values >200 mg/dL, >130 mg/dL, <40 mg/dL, respectively; and/or, triglyceride values >150 mg/dL defined cases of dyslipidemia. Prevalence and predictors of dyslipidemia were compared between the two groups. RESULTS prevalence of dyslipidemia was significantly higher among cART experienced (70.2%) than treatment naïve (58.1%) children (p = 0.03). Prevalence of low HDLc (40.2% versus 23.4%, p = 0.006) and hypertriglyceridemia (47.2% versus 35.8%, p = 0.02) was higher among cART experienced than naïve children. There was no difference in total hypercholesterolemia and high LDLc levels. Nutrition state was associated with dyslipidemia among cART naïve children (p = 0.01). CONCLUSION high prevalence of cART-associated dyslipidemia, particularly low HDLc and hypertriglyceridemia was observed among treatment experienced HIV-infected children. The findings underscore the need for regular follow up of children on cART for lipid abnormalities.
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Affiliation(s)
- Birkneh Tilahun Tadesse
- Department of Pediatrics, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Byron Alexander Foster
- Departments of Dermatology and Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Adugna Chala
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | | | - Temesgen Bizuayehu
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Freshwork Ayalew
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Getahun H/Meskel
- School of Laboratory Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia.
| | - Sintayehu Tadesse
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | - Degu Jerene
- Management Sciences for Health, Addis Ababa, 1250, Ethiopia.
| | - Eyasu Makonnen
- Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
- CDT Africa, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia.
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
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Lopez MF, Zheng L, Miao J, Gali R, Gorski G, Hirschhorn JN. Disruption of the Igf2 gene alters hepatic lipid homeostasis and gene expression in the newborn mouse. Am J Physiol Endocrinol Metab 2018; 315:E735-E744. [PMID: 30016152 PMCID: PMC6293172 DOI: 10.1152/ajpendo.00048.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/14/2018] [Accepted: 07/06/2018] [Indexed: 11/22/2022]
Abstract
Newborns with intrauterine growth-restriction are at increased risk of mortality and life-long comorbidities. Insulin-like growth factor-II (IGF2) deficiency in humans, as well as in mice, leads to intrauterine growth restriction and decreased neonatal glycogen stores. The present study aims to further characterize the metabolic and transcriptional consequences of Igf2 deficiency in the newborn. We found that, despite being born significantly smaller than their wild-type ( Igf2+/+) littermates, brain size was preserved in Igf2 knockout ( Igf2-/-), consistent with nutritional deficiency. Histological and triglyceride analyses of newborn livers revealed that Igf2-/- mice are born with hepatic steatosis. Gene expression analysis in Igf2-/- newborn livers showed an alteration of genes known to be dysregulated in chronic caloric restriction, including the most upregulated gene, serine dehydratase. Multiple genes connected with lipid metabolism and/or hepatic steatosis were also upregulated. Ingenuity Pathway Analysis confirmed that the biological functions most altered in livers of Igf2-/- newborns are related to lipid metabolism, with the top upstream regulator predicted to be the peroxisome proliferator-activated receptor alpha, a master regulator of hepatic lipid and carbohydrate homeostasis. Together, our data indicate that Igf2 deficiency leads to a newborn phenotype strongly reminiscent of nutritional deficiency, including growth retardation, increased brain/body weight ratio, hepatic steatosis, and characteristic changes in hepatic gene expression. We propose that in addition to its growth factor proliferating functions, Igf2 may also regulate growth by altering the expression of genes that control nutrient metabolism in the newborn.
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Affiliation(s)
- Mary Frances Lopez
- Center for Basic and Translational Obesity Research , Boston, Massachusetts
- Endocrine Division, Boston Children's Hospital , Boston, Massachusetts
- Harvard Medical School , Boston, Massachusetts
| | - Lingyun Zheng
- Endocrine Division, Boston Children's Hospital , Boston, Massachusetts
| | - Ji Miao
- Endocrine Division, Boston Children's Hospital , Boston, Massachusetts
- Harvard Medical School , Boston, Massachusetts
| | - Reddy Gali
- Harvard Medical School , Boston, Massachusetts
- The Harvard Clinical and Translational Science Center and Countway Library of Medicine , Boston, Massachusetts
| | - Grzegorz Gorski
- Center for Basic and Translational Obesity Research , Boston, Massachusetts
| | - Joel N Hirschhorn
- Center for Basic and Translational Obesity Research , Boston, Massachusetts
- Endocrine Division, Boston Children's Hospital , Boston, Massachusetts
- Harvard Medical School , Boston, Massachusetts
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