Increased resting energy expenditure, fat oxidation, and food intake in patients with highly active antiretroviral therapy-associated lipodystrophy

Abstract

Highly active antiretroviral therapy (HAART) is associated with metabolic adverse events such as lipodystrophy in human immunodeficiency virus (HIV)-infected patients. The objective of the present study was to evaluate the effects of HAART-associated lipodystrophy on resting energy expenditure and caloric intake. In this cross-sectional study we compared resting energy expenditure (REE) and energy intake in 30 HAART-treated patients with lipodystrophy (HAART+LD+) with 13 HAART-treated patients without lipodystrophy (HAART+LD−). REE was measured using indirect calorimetry, and energy intake was recorded as a 3-day diary of food intake. REE (5,180 ± 160 vs. 4,260 ± 150 J/min, P < 0.01) and also REE expressed per fat-free mass (86 ± 1 vs. 78 ± 2 J·kg fat-free mass−1·min−1, P < 0.01) were significantly higher in the HAART+LD+ than the HAART+LD− group. Rate of lipid oxidation was significantly higher in the HAART+LD+ than the HAART+LD− group. Total energy and fat intakes were significantly increased in the HAART+LD+ compared with the HAART+LD− group. These results imply that HAART-associated lipodystrophy is associated with increased REE and lipid oxidation and with increased caloric and fat intake.