title: Agreement analysis of variables involved in lipodystrophy syndrome definition in HIV-infected patients.
abstract: BACKGROUND
  Lipodystrophy studies in HIV-infected patients have usually defined abnormalities in body fat by clinical evaluation and patient questionnaires. Despite the risk for bias with these subjective approaches, agreement analysis among the large number of variables employed was seldom performed.
  
  
  OBJECTIVE
  To analyze consistency between the usual approaches for definition of abnormalities in body fat distribution.
  
  
  METHODS
  We evaluated agreement between the clinical and questionnaire findings for abnormalities in body fat in an HIV patient population under antiretroviral treatment followed in our institution, using different criteria for definitions of body fat abnormalities within the same data set.
  
  
  METHODS
  Kappa analysis for consistency and receiver-operator characteristic (ROC) curve analysis were performed.
  
  
  RESULTS
  Low levels of agreement between clinical and patient perspectives were observed. Only one combination of criteria showed adequate agreement results. The waist/hip ratio showed low levels of agreement with all other variables, and no clear discriminative point was observed by ROC curve analysis. The ratio between the trunk fat content and the leg fat content assessed by dual energy x-ray absorptiometry (DEXA) scan demonstrated better agreement and more clear discriminative values for both male and female patients.
  
  
  CONCLUSIONS
  Agreement analyses may help in the selection of the subjective variable methodology and in the inclusion of consistent and nonredundant objective measurements for diagnosis of abnormalities in body fat.
authors.affiliation: Internal Medicine Service, Intensive Care Medicine Service, Hospital de Buenos Aires, Argentina. wbelloso@hitalba.edu.ar
authors.forename: Waldo H
authors.initials: WH
authors.lastname: Belloso
authors.forename: Rodolfo E
authors.initials: RE
authors.lastname: Quirós
authors.forename: Silvia A
authors.initials: SA
authors.lastname: Ivalo
authors.forename: Mario I
authors.initials: MI
authors.lastname: Perman
authors.forename: Ana M
authors.initials: AM
authors.lastname: Galich
authors.forename: Liliana D
authors.initials: LD
authors.lastname: Stern
authors.forename: Laura A
authors.initials: LA
authors.lastname: Barcán
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D001824:Body Constitution; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012372:ROC Curve; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires