HARC 016 - HIV-1-Associated Lipodystrophy and Metabolic Abnormalities: Efficacy and Safety of Testosterone Administration.  This protocol was developed and incorporated as part of a grant application for developing a Center of Clinical Research Excellence by the University of Hawaii/Kapiolani Medical Center for Women and Children.  This study proposes to study the impact of testosterone on glucose and lipid metabolism and to explore the possible pathophysiologic mechanisms underlying these metabolic abnormalities in HIV-1-infected individuals.  Insulin resistance will be evaluated with the use of frequently sampled intravenous glucose tolerance test (FSIGT).  The role of lipolytic enzymes in lipodystrophy will be explored with the determination of post-heparin lipoprotein lipase (PH-LPL) and hepatic lipase (HL) activity.  The role of macrophages in the pathogenesis of lipodystrophy will be assessed by the determination of macrophage LPL and tumor necrosis factor-alpha (TNF-a mRNA expression in peripheral blood mononuclear cells and adipose tissue macrophages.  Aspiration of subcutaneous adipose tissue from the anterior abdominal wall will be examined histologically and for mRNA expression of adipose LPL, TNF-a, macrophage colony stimulating factor and PPAR-g.  Adipose tissue samples will also be stored at -70 C for future analysis of potential gene markers.

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