Longitudinal Study of Body Composition of 101 HIV Men With Lipodystrophy: Dual-Energy X-Ray Criteria for Lipodystrophy Evolution |
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| Authors: | Emilie Degris Cyrille Delpierre Agnès Sommet Stèphane Sire Slim Lassoued Christian Aquilina Bruno Marchou Patrice Massip Martine Obadia Fabrice Marion-Latard Eric Bonnet Jacques Bernard |
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| Institution: | 1. Unit of Pharmacy, Paule de viguier Hospital, Toulouse, France;2. INSERM U558, Toulouse, F-31073, France;3. Unit of Clinical Pharmacology, Purpan Hospital, Toulouse, France;4. Unit of Infectious and Tropical Disease, Cahors Hospital, France;5. Unit of Rheumatology and Physical Therapy, Cahors Hospital, France;6. Unit of Dermatology, La Grave Hospital, Toulouse, France;7. Unit of Infectious and Tropical Disease, Purpan Hospital, Toulouse, France;8. Unit of Sport Medicine, Rangueil Hospital, Toulouse, France;9. Unit of Rheumatology, Rangueil Hospital, Toulouse, France;1. Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Zurawia Str. 14, 15-540 Bialystok, Poland;2. Department of Anaesthesiology and Intensive Therapy, Faculty of Health Sciences, Medical University of Bialystok, Poland;1. Indiana University School of Medicine, Indianapolis, IN, USA;2. Case Western Reserve University, Cleveland, OH, USA;3. JOSHA Research, Bloemfontein, South Africa;4. Hospital Nacional Cayetano Heredia, Lima, Peru;5. Desmond Tutu HIV Foundation, Cape Town, South Africa;6. HIV-NAT, Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;7. Triple O Research Institute, West Palm Beach, FL, USA;8. Centro Glucomedi, Mexico City, Mexico;9. Bristol-Myers Squibb, Princeton, CT, USA;10. Bristol-Myers Squibb, Wallingford, NJ, USA;1. Department of Internal Medicine, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil;2. Health Promotion Program, University of Franca, Franca, São Paulo, Brazil;1. Department of Endocrinology, Metabolic diseases and Nutrition, l''institut du thorax, CHU de Nantes, Nantes, France;2. CRNH, Human Nutrition Research Center, CHU, Nantes, France;3. INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Hôtel-Dieu, Nantes, France;4. Inserm UMR1188 DéTROI, Université de La Réunion, CHU de la Réunion, Sainte Clotilde, France;1. Allergy Partners of North Texas, Dallas, Texas;2. Medical City Children''s Hospital, Dallas, Texas |
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| Abstract: | The aim of this study was to define evolution profiles of body composition among human immunodeficiency virus (HIV)-infected men with lipodystrophy. The design is a retrospective analysis using observational data collected longitudinally. We included 101 HIV-infected men with lipodystrophy managed in routine practice and who had 2 dual energy X-ray absorptiometry scans within a minimum interval of 18 mo. Lipodystrophy was defined as a fat mass ratio (FMR, defined as the ratio of the percentage of the trunk fat mass over the percentage of the lower limbs fat mass) equal or superior to 1.5. Patients were classified in “improved” group (IG: increase of lower limbs fat mass ≥ 10%) or “nonimproved” group (NIG). Body composition, immunovirological and epidemiological data were collected and compared between the 2 groups. In the whole population, over a 4-yr period, a significant increase was observed for total fat mass, trunk fat mass, and lower limbs fat mass, whereas total lean mass was stable. Total body mineral density decreased. Fifty-nine patients (IG), less exposed to zidovudine than the NIG, had an increase of lower limbs fat mass higher than 10%. But only 13 (22%) regained a normal distribution of fat mass (FMR < 1.5), showing that lipodystrophy was slowly reversible. Among the NIG, 5 patients (11.9%), less exposed to zidovudine and with a higher mean of viral load, reached an FMR below 1.5. It was mainly because of a loss of trunk fat mass, which could be the sign of a lipodystrophy worsening. Lipodystrophy improved for 58.4% of men. The improvement was very slow. Recovery was observed only in patients with an earlier intervention. No correlation was observed between lipodystrophy and total body bone mineral density. The loss of trunk fat mass without gain of lower limbs fat mass may indicate a worsening of HIV disease. |
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