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

AIDS. 1999 Jul 30;13(11):1359-65. doi: 10.1097/00002030-199907300-00013.


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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anthropometry
  • Blood Glucose / metabolism
  • Body Constitution*
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Cross-Sectional Studies
  • Fasting
  • HIV Infections / blood
  • HIV Infections / immunology
  • HIV Infections / physiopathology*
  • HIV Wasting Syndrome / blood
  • HIV Wasting Syndrome / immunology
  • HIV-1 / physiology
  • Humans
  • Hyperinsulinism*
  • Insulin / blood*
  • Male
  • RNA, Viral / blood


  • Blood Glucose
  • Insulin
  • RNA, Viral