Severely dysregulated disposal of postprandial triacylglycerols exacerbates hypertriacylglycerolemia in HIV lipodystrophy syndrome

Rajagopal V. Sekhar, Farook Jahoor, Henry J. Pownall, Khaleel Rehman, John Gaubatz, Dinakar Iyer, Ashok Balasubramanyam

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Background: The pathogenesis of hypertriacylglycerolemia, a characteristic feature of HIV lipodystrophy syndrome (HLS), is incompletely understood. One mechanism is accelerated lipolysis in the fasted state, but the severity of the hypertriacylglycerolemia suggests that additional underlying abnormalities may exist in the disposal of dietary fat. Objective: Our objective was to investigate abnormalities in dietary fat disposal in the pathogenesis of hypertriacylglycerolemia in HLS. Design: We studied 6 nondiabetic men with HLS and 6 men without HIV matched for age and body mass index as control subjects for 8 h after consumption of an isocaloric meal containing 2 g labeled [ 13C3]tripalmitin. Chylomicron-triacylglycerol disposal was estimated from labeled [13C1]palmitate in the plasma chylomicron fraction, and [13C1]palmitate oxidation was estimated from the 13CO2 enrichment in the breath and CO2 production, over 8 h after the meal. Results: HLS patients had significantly elevated concentrations of fasting plasma triacylglycerols in both chylomicron (x̄ + SE: 100.3 ± 49.5 compared with 29.2 ± 2.2 mg/dL; P < 0.01) and VLDL (82.4 ± 39.0 compared with 10.8 ± 2.8 mg/dL; P < 0.01) fractions. Chylomicron-triacylglycerol-derived [ 13C1]palmitate disposal was markedly lower in the HLS patients (3.09 ± 0.41 compared with 6.42 ± 0.18 mmol [ 13C1]palmitate/8 h; P < 0.001) in the 8-h postmeal period. Further, HLS patients had lowered storage of chylomicron- triacylglycerols (0.74 ± 0.38 compared with 5.05 ± 0.16 mmol; P < 0.0001) and elevated plasma[13C1]palmitate concentrations (2.01 ± 0.27 compared with 1.18 ± 0.16 mmol; P < 0.05) 8 h after the meal. Conclusions: Patients with HLS have key defects that markedly impair postprandial disposal and storage of chylomicron- triacylglycerols. These defects contribute significantly to hypertriacylglycerolemia in HLS.

Original languageEnglish (US)
Pages (from-to)1405-1410
Number of pages6
JournalAmerican Journal of Clinical Nutrition
Volume81
Issue number6
DOIs
StatePublished - 2005

Keywords

  • Cholesteryl ester
  • Fat oxidation
  • Lipolysis
  • Lipoprotein lipase

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

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