Lipodystrophy Clinical Trial
Official title:
Study of Histological and Adipokines Expression Variations in Lipodystrophic Adipose Tissue During Corticosteroids-induced Lipodystrophy
Hypothesis: systemic therapy with corticosteroid induces morphological changes (e.g., moon
face, buffalo neck) called lipodystrophy (LD). We hypothesize that this LD is associated
with variation of adipocytokines (e.g., adiponectin, leptine, IL6) levels
Primary objective: To show a 50% decrease in adipocytes adiponectin's expression in patients
who developed LD versus those who did not developed LD during the first 3 months of a
systemic therapy with corticosteroids
Secondary objectives: To look for differences in the mRNA expression of 11bHSD1, SREBP1c and
PPARg in fat samples of patients before and after treatment with systemic corticosteroids
and between LD+ and LD-patients To compare the fat morphology before and after treatment
with glucosteroids
Design: Monocentric, cross-sectional analytical study
Subjects: 32 HIV-free and Cushing disease-free adult patients for whom a prolonged treatment
(³3months) with glucosteroids (³ 0.5 mg/kg/day) is initiated
Methods: At treatment initiation and 3 months after: comparison of fat sample mRNA
expression of adipokines (adiponectin, leptin, IL6, TNFa), 11bHSD1, SREBP1c and PPARg, fat
morphology and seric concentrations of adiponectin, leptin, IL6, sTNFR1 between patients LD+
and patients LD-. The diagnosis of LD will be performed by 3 experts using patients
photographs
Aims of this study:
- To gain a better understanding of the pathophysiology of glucosteroids-induced LD
- To compare this pathophysiology to the one of HIV-associated LD for which the
hypothesis of a local, cellular, hypercorticism has been put forward and for which
related treatment have been prescribed.
;
Observational Model: Cohort, Time Perspective: Prospective
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