Original ArticleLongitudinal Study of Body Composition of 101 HIV Men With Lipodystrophy: Dual-Energy X-Ray Criteria for Lipodystrophy Evolution
Section snippets
Background
Dual-energy X-ray absorptiometry (DXA) is a reliable technique for measuring total body and regional bone mineral and soft tissue composition. Its usefulness for evaluating fat redistribution in metabolic diseases and for improving early detection and diagnosis of lipodystrophy has become increasingly evident 1, 2.
Soon after highly active antiretroviral therapy became available, fat redistribution and osteopenia have become 2 major concerns for human immunodeficiency virus (HIV)–treated persons
Study Design
We performed a retrospective analysis using observational data collected longitudinally on HIV-infected men with lipodystrophy. All the patients came from the hospital at Cahors, France and 2 French university hospital outpatient units in Toulouse: the unit of infectious and tropical diseases, Purpan hospital, and the unit of dermatology, La Grave hospital.
Subjects and Groups
All men were older than 18 yr, at steady state, without active opportunistic infection or malignancy and treated for HIV infection before
Results
We included 101 HIV-infected men with lipodystrophy. DXA scans were conducted between June 2001 and June 2007. The mean interval between the 2 DXA scans was 46.4 ± 14.7 mo (median: 51 mo, interquartile range: 34–59).
Discussion
To our knowledge, this study is the longest observation of a large cohort of HIV-infected men with objective criteria of lipodystrophy. The population is homogenous regarding disease history and steady immunovirologic data.
Concerning the whole population, a gain in total fat mass, trunk fat mass, and lower limbs fat mass was observed between the 2 DXA scans. Lipodystrophy improved in 58% of patients, sign of the awareness of physicians regarding this problem. As shown in previous studies, we
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2017, Journal of Clinical DensitometryCitation Excerpt :However, if the visual perception of the investigator did not agree with the report of the patient, lipodystrophy was not diagnosed. In addition to the subjective diagnosis of lipodystrophy, it is also possible to calculate the fat mass ratio (FMR), that is, the ratio between trunk fat and lower limb fat, both obtained by DXA, an extensively used method also for the classification of lipodystrophy (17,21–25). Another measurement usually applied is based on muscle mass indices developed to classify individuals with SP and to compare them to a reference population of young individuals (26).
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2012, Clinical NutritionCitation Excerpt :It is worth emphasizing here that the reference values (25th–75th percentile range) for limb FM% differ considerably between men and women. These percentiles will be very useful in assessing limb FM both for associated metabolic and vascular risks and to identify lipoatrophic and lipodystrophic conditions, in HIV-infected men treated with antiretroviral therapy for instance.31 In this case, the early identification of lipoatrophy may enable action to be taken before the point of no return is reached.
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