Lipodystrophy
Conditions
Keywords
Lipodystrophy, Adipokines, Glucocorticoids, Patients with glucocorticoids
Brief summary
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
Detailed description
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.
Interventions
OTHERSamples and procedures
* Scanner, histomorphometry : at the inclusion and M3 visits * whole blood samples, cytoponction : at the inclusion and M3 visits
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patient * starting therapy with prednisone * corticosteroid therapy lasting more than 3 months * baseline prednisone dosage \>= 0.5 mg/kg/d
Exclusion criteria
* Cushing disease * HIV +Pregnancy * Recent weight lost (\> 5% of the usual weight) * Therapy with glucocorticosteroids during the past 6 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expression of adiponectin in adipocytes | at the inclusion and M3 visits |
Secondary
| Measure | Time frame |
|---|---|
| Plasma levels of adiponectin, leptin, sTNFR1, and IL6 | at the inclusion and M3 visits |
| Histological morphology of adipocytes | at the inclusion and M3 visits |
| Expression of leptin, IL6, TNFa, 11bHSD1, SREBP1c and PPARg in adipocytes | at the inclusion and M3 visits |
Countries
France
Outcome results
None listed