Tesamorelin May Reduce Insulin Resistance in HIV With Lipodystrophy

Patients with HIV and abdominal fat who received tesamorelin experienced positive changes in fasting blood glucose and glycated hemoglobin A1c.

This article is part of Endocrinology Advisor‘s coverage of the 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress, taking place in Austin, Texas. Our staff will report on medical research and technological advances in diabetes, obesity, and thyroid conditions, conducted by experts in the field. Check back regularly for more news from AACE 2017.

Liver damage in patients with HIV and abdominal fat is associated with insulin resistance, according to research presented at the 26th Annual American Association of Clinical Endocrinologists (AACE) Scientific & Clinical Congress, May 3-7, 2017, in Austin, TX.

Researchers from Massachusetts General Hospital and McGill University Health Center analyzed data from 2 phase 3 studies of tesamorelin use in patients with HIV and excessive abdominal fat to identify “responders,” defined as participants who experienced ≥8% reduction in visceral adipose tissue (VAT).

Tesamorelin is a stabilized analogue of human growth-releasing hormone that has been previously shown to reduce VAT in patients who are HIV positive with lipodystrophy.

Among patients who received tesamorelin therapy for 26 weeks, changes in alanine aminotransferase levels correlated significantly with changes in fasting blood glucose and glycated hemoglobin A1c (HbA1c; P <.025 and P =.036, respectively). Changes in participants without hepatitis B or C were positively correlated with changes in fasting blood glucose and HbA1c (r=0.14 and 0.13; P =.061 and .076, respectively).

Positive changes were also noted in responders who underwent tesamorelin therapy for 52 weeks, with positive associations noted in fasting blood glucose, fasting insulin, and homeostatic model assessment-insulin resistance (r=0.21, 0.21, and 0.22;  P =.09, .085, and .084, respectively); negative correlations were noted with adiponectin (r=0.29; P =.041).

“Changes in liver transaminases were associated with changes in glucose parameters and adiponectin in tesamorelin responders,” the researchers concluded. “This finding may account for the preservation of glucose homeostasis seen in these patients.”

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Reference

Mamputu J-C, Stanley T, Falutz J, et al. Association of changes in liver transaminases with changes in glucose parameters and adiponectin in HIV-infected patients treated with tesamorelin, a growth hormone-releasing hormone analogue. Abstract 851. Presented at: 26th Annual American Association of Clinical Endocrinologists Scientific & Clinical Congress. May 3-7, 2017; Austin, TX