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Drugs Improve Insulin Sensitivity in HIV Infection

Drugs do not appear to reduce visceral fat

WEDNESDAY, Jan. 3 (HealthDay News) -- Metformin and rosiglitazone can improve insulin sensitivity but not reduce visceral fat in HIV-infected patients with insulin resistance and changes in fat distribution, according to a report in the Jan. 2 issue of AIDS.

Kathleen Mulligan, Ph.D., from San Francisco General Hospital in California, and colleagues randomly assigned 105 HIV-infected patients with insulin resistance and changes in fat distribution to either metformin, rosiglitazone, both, or a placebo for 16 weeks.

The researchers found a significant decrease in the mean insulin area under the curve (AUC) in patients treated with rosiglitazone either alone or combined with metformin, and the change in the AUC was significant compared with placebo for the combination therapy. Metformin tended to decrease the mean insulin AUC. However, neither treatment affected visceral or subcutaneous abdominal fat, and rosiglitazone increased leg fat, adiponectin and low-density lipoprotein cholesterol, and decreased high-density lipoprotein cholesterol.

"Both treatments improved insulin sensitivity, but neither reduced visceral fat," Mulligan and colleagues conclude. "Rosiglitazone may increase subcutaneous fat in some individuals."

Pharmaceutical support provided by Bristol-Myers Squibb Company and GlaxoSmithKline, Inc.

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