The dysregulation of adipokines in the synergy of diabetes and HIV infection

Abstract

Background: Dysregulated production or secretion of adipokines from adipose tissue may contribute to the pathogenesis of obesity-linked complications such as diabetes mellitus (DM). Although adipokines have anti-inflammatory activity it is also capable of causing inflammation. Human immunodeficiency virus (HIV) infection predisposes an individual to the development of diabetes. Notwithstanding the side effects of antiretroviral therapy (ART), these may also exacerbate adipokine release and thereby promoting metabolic abnormalities.
Aim: This study reviews adipokines in the synergy of diabetes comorbid with HIV infection. It also examines the ameliorative action of ART on adipokines in diabetes.
Method: Multiple databases were used to search for each of the adipokines listed in the study. The role and expression of these adipokines were highlighted in its relationship to DM and HIV. Relevant articles were identified, selected and used to write this review article.
Results: This narrative review compares adipokine levels among HIV-infected and uninfected patients who are diabetic and have insulin resistance (IR). It also addresses the side effect of ART and its contribution to DM in HIV-infected patients. Adipokines are dysregulated in diabetes and IR, as well as in patients receiving ART.
Conclusion: ART, particularly protease inhibitors and non-nucleoside reverse transcriptase inhibitors, promotes IR and metabolic abnormalities. Nonetheless, obesity, physical inactivity, immune dysregulation and inflammation are also contributing factors to IR and DM in HIV-infected patients. Finally, circulating levels of adipokines are dysregulated in DM and further investigations are necessary.