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Health Benefits Shown for Trimming Belly Fat

, by Reilly O'Neal

Within a few years after combination antiretroviral therapy became available, people taking the new medications began to experience changes in body shape, due to shifts in where fat is either lost or built up in the body.

Fat accumulation, or “lipohypertrophy,” can occur in the breasts, in the upper back and at the base of the neck, and in the belly. This kind of deep belly fat is known as “visceral adipose tissue” (VAT)—in other words, fat (adipose tissue) that surrounds the abdominal organs (viscera). Accumulated fat that produces a high waist-to-hip ratio, giving the body an “apple” shape, has been linked with risk of cardiovascular disease.

Tesamorelin (brand-name Egrifta) is an injectable drug approved in 2010 to help reduce excess VAT associated with HIV treatment. (To learn how tesamorelin works in the body, see “Drug Watch: Tesamorelin Update” in the Summer/Fall 2010 issue of BETA.)

An analysis of data from two studies, published in the June 1, 2012, issue of Clinical Infectious Diseases, offers good news for people who are using tesamorelin and responding well to the drug: Individuals who saw their VAT decrease by at least 8% experienced significantly bigger improvements in “levels of triglycerides and adiponectin and preservation of long-term glucose homeostasis over 52 weeks.”

What does that mean? Basically, it gives insight into avoiding “metabolic syndrome,” a common complication of HIV and its treatment. Metabolic syndrome is a combination of conditions—including high triglycerides, high blood sugar, excess fat around the waist, low HDL (“good”) cholesterol, and high blood pressure—that together increase the risk for stroke, heart disease, and diabetes.

  • Triglycerides are a type of fat found in the bloodstream. As the amount of this type of fat in the blood increases beyond healthy levels, the risk of heart attack or stroke also climbs.
  • Glucose homeostasis” refers to the body’s ability to regulate blood sugar (glucose). Blood glucose levels are managed largely by the hormone insulin.
  • The hormone adiponectin, in turn, plays a part in the development of insulin resistance, in which insulin becomes less effective at controlling blood sugar. Insulin resistance marks an early step toward diabetes and is implicated in atherosclerosis, or hardening of the arteries. Lower levels of the hormone adiponectin are found in obese individuals.

In this analysis of two advanced (Phase III) clinical trials, people who achieved at least an 8% reduction in belly fat on tesamorelin had greater improvements in these markers of metabolic syndrome. Their triglyceride levels went down more, their adiponectin levels went up more, and they were better able to maintain their blood sugar levels compared with participants who did not respond to tesamorelin.

The researchers note that these findings indicate “metabolic benefits associated with reducing VAT in this population.” In short, getting deep belly fat under control may go far toward avoiding the health risks linked with metabolic syndrome.

Reilly O’Neal is a freelance writer and former editor of BETA.

Selected Sources

Bernasconi, E. and others. Abnormalities of body fat distribution in HIV-infected persons treated with antiretroviral drugs. JAIDS 31(1):50–55. September 1, 2002.

Stanley, T. and others. Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clinical Infectious Diseases 54(11):1642-51. June 2012.


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