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Biomedical subjects

C Waslien

Publications and source records attributed to C Waslien.

4 recordsLinked to original sources

Mitochondrial DNA decrease in subcutaneous adipose tissue of HIV-infected individuals with peripheral lipoatrophy.

OBJECTIVE: To determine whether the peripheral fat wasting (lipodystrophy), which is seen in association with highly active antiretroviral therapy (HAART) that includes a nucleoside reverse transcriptase inhibitor (NRTI), is associated with a decrease in subcutaneous adipose tissue mitochondrial DNA (mtDNA) content or with large mtDNA deletions or insertions. DESIGN: A four cohort cross-sectional study. METHODS: The mtDNA content of subcutaneous fat tissue from the neck, abdomen and thigh was determined by polymerase chain reaction utilizing the amplification of three different mtDNA fragments. The results from HIV-infected patients with peripheral fat wasting following more than 6 months of NRTI-containing HAART were compared with the results from three different control cohorts: HIV-infected patients with a similar treatment history without lipodystrophy; HIV-infected patients naive to antiretroviral therapy and HIV sero-negative participants. RESULTS: A decrease in mtDNA content was found in HAART-treated HIV-infected patients with peripheral fat wasting in comparison with subjects in the control cohorts. No large mitochondrial deletions or insertions were found. CONCLUSIONS: Lipodystrophy with peripheral fat wasting following treatment with NRTI-containing HAART is associated with a decrease in subcutaneous adipose tissue mtDNA content.

Adipose Tissue↗

Fasting hyperinsulinemia and increased waist-to-hip ratios in non-wasting individuals with AIDS.

OBJECTIVE: To identify metabolic and body composition changes associated with HIV-1 infection in a cross-sectional study of individuals stratified by immunologic status and body mass. DESIGN: Metabolic abnormalities including glucose intolerance and changes in body morphology have recently been described in HIV-1-infected individuals following therapy with protease inhibitor-containing highly active anti-retroviral therapy. Although this is suggestive of a direct drug effect, the possibility that HIV infection may induce a tendency towards such underlying derangements should be considered. HIV-infected patients are heterogeneous with respect to immunologic status and body mass. In examining the underlying effect of HIV-1 on metabolic and body composition parameters, stratification by various immunologic and body mass categories may give divergent results that would not be detected otherwise. METHODS: Thirty male participants were categorized into four cohorts: non-wasting HIV-seronegative controls, non-wasting HIV-infected patients with relatively intact immune function (CD4 cell count > 500 x 10(6)/l); non-wasting individuals with AIDS (CD4 cell count < 200 x 10(6)/l); and individuals with AIDS wasting. RESULTS: Increased fasting plasma insulin and waist-to-hip ratios were found specifically in non-wasting individuals with AIDS compared with HIV-negative controls. CONCLUSIONS: Our study emphasises the importance of both body mass and immune function in studying metabolic and body composition abnormalities associated with HIV-1 infection. The association of increased waist-to-hip ratios and hyperinsulinemia suggestive of insulin resistance in non-wasting individuals with AIDS suggest that the tendency towards these metabolic abnormalities may be related to the HIV infectious process or to factors associated with immunologic dysfunction.

Anthropometry↗

The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly.

Although common among the hospitalized frail elderly, malnutrition is often unrecognized by clinicians, and its identification is fought with difficulty due to inadequate nutritional assessment methods and standards. This study compared the use of percent ideal body weight (%IBW) and anthropometry in the assessment of malnutrition in the hospitalized frail elderly. Approximaty 45% of patients studied had at least two anthropometric measurements below the 5th percentile, a level reflecting severe malnutrition. However, only 28% of patients were found to be less than 90% IBW, a level reflecting only mild to severe changes in body weight. Serum albumin was below normal (< 35 g/l) in 30% of patients. The total lymphocyte count was below normal (< 1,500 cells/mm3) in 53%, and was severely depressed (< 800 cells/mm3) in 24%. Thus, despite the use of stringent anthropometric criteria indicating severe malnutrition, anthropometry appeared more sensitive than %IBW as a measure of malnutrition in the hospitalized frail elderly. Furthermore, acute illness causes changes in commonly employed blood measures which make them unreliable in the assessment of malnutrition in this population. Anthropometry may prove to be the most stable, easily performed, and sensitive measure of malnutrition in the hospitalized frail elderly. However, further studies are clearly needed, including the development of appropriate anthropometric reference standards for the very old, a population that commonly suffers malnutrition.

Aged↗