Obesity Clinical Trial
Official title:
Effect of Diet, Exercise and Rosiglitazone on Regional Fat and Insulin Resistance in HIV-Infected and Uninfected Men and Women
The purpose of this study is to determine if, in men and women with excess abdominal fat and
insulin resistance, people with HIV infection respond differently than people without HIV to
interventions that typically improve body fat distribution and insulin resistance. The
specific interventions are:
1. Diet + exercise program.
2. Rosiglitazone treatment.
3. A combination treatment of diet + exercise program and rosiglitazone.
A constellation of nutritional alterations in HIV-infected patients receiving highly active
antiretroviral therapies (HAART), including body fat redistribution with subcutaneous
adipose tissue (SAT) wasting and visceral adipose tissue (VAT) accumulation, hyperlipidemia,
and insulin resistance (IR) has been described. There is a major concern that these
developments will be associated with adverse clinical outcomes related to atherosclerosis,
as suggested by several case reports (Henry 1998, Behrens 1998, Gallet 1998, Vittecoq 1998).
Although there are well documented associations among body fat distribution, insulin
resistance, and adverse health outcomes, especially accelerated atherosclerosis, in non-HIV
infected individuals, it is unclear if the relationships are affected by HIV infection, or
if they reflect the same outcomes. This information is important, since understanding the
interrelationships between body fat distribution and metabolism may guide the development of
treatment strategies.
The specific hypotheses to be tested are:
1. HIV infection does not affect the relative reductions in visceral (VAT) and
subcutaneous adipose tissue (SAT) resulting from diet + exercise, but decreases the
effect of this therapy on insulin resistance.
2. HIV infection decreases the changes in insulin resistance and body composition
(increase in SAT and decrease in VAT) expected with rosiglitazone.
3. The combination treatment of diet+exercise and rosiglitazone will reduce VAT to a
greater extent than rosiglitazone alone, and will improve insulin resistance to greater
extent than diet and exercise alone, however these effects will be blunted in
HIV-infected subjects.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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