Glucose production pathways by 2H and 13C NMR in patients with HIV-associated lipoatrophy

Magn Reson Med. 2004 Apr;51(4):649-54. doi: 10.1002/mrm.20057.


Patients with HIV taking protease inhibitors were selected for the presence (five subjects) or absence (five subjects) of lipoatrophy. Following an overnight fast, subjects were given oral (2)H(2)O in divided doses (5 mL/kg body water), [U-(13)C(3)] propionate (10 mg/kg), and acetaminophen (1000 mg). Glucose (from plasma) or acetaminophen glucuronide (from urine) were converted to monoacetone glucose for (2)H NMR and (13)C NMR analysis. The fraction of plasma glucose derived from gluconeogenesis was not significantly different between groups. However, flux from glycerol into gluconeogenesis relative to glucose production was increased from 0.20 +/- 0.13 among subjects without lipoatrophy to 0.42 +/- 0.12 (P < 0.05) among subjects with lipoatrophy, and the TCA cycle contribution was reduced. Lipoatrophy was associated with an abnormal profile of glucose production as assessed by (13)C and (2)H NMR of plasma and urine.

Publication types

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

MeSH terms

  • Acetaminophen / analogs & derivatives*
  • Acetaminophen / urine
  • Blood Glucose / analysis
  • Carbon Isotopes
  • Citric Acid Cycle
  • Deuterium
  • Fasting
  • Female
  • Gluconeogenesis
  • Glucose / biosynthesis*
  • Glycerol / metabolism
  • HIV Protease Inhibitors / therapeutic use
  • HIV-Associated Lipodystrophy Syndrome / metabolism*
  • Humans
  • Magnetic Resonance Spectroscopy*
  • Male
  • Middle Aged
  • Plasma / chemistry
  • Propionates
  • Water


  • Blood Glucose
  • Carbon Isotopes
  • HIV Protease Inhibitors
  • Propionates
  • Water
  • Acetaminophen
  • acetaminophen glucuronide
  • Deuterium
  • Glucose
  • propionic acid
  • Glycerol