Association between Lipodystrophy, Leptin and hepatic Steatosis in People living with HIV in use of antiretroviral therapy

People with HIV Lipodystrophy Syndrome may experience disturbance in leptin levels. This hormone is associated with non-alcoholic liver steatosis and endocrine-metabolic changes. The objective of this study was to evaluate the association between hepatic steatosis, leptin levels and clinical forms of Lipodystrophy. This is a cross-sectional study, conducted with 62 patients with Lipodystrophy using antiretroviral therapy (ART). The variables studied were anthropometry, laboratory tests and clinical data. Regarding the patients diagnosed with hepatic steatosis, 92% (n = 23) had a mixed or hypertrophic form (p = 0.02). Patients with hepatic steatosis had higher levels of leptin, insulin and HOMA IR, compared to those without steatosis. The correlation between leptin, insulin and body fat was not significant in this series (p> 0.05). There was no correlation between the duration of ART use and hepatic steatosis (p = 0.76). The classes most associated with steatosis were nucleoside analog reverse transcriptase inhibitors and protease inhibitors. Zidovudine was present in 20% (n = 5) of the cases with steatosis and 2.7% (n = 1) of the cases without steatosis. Patients with lipohypertrophy had higher levels of leptin and a higher prevalence of hepatic steatosis. Patients with hepatic steatosis had significantly higher leptin levels.