[Eucaloric substitution of medium chain triglycerides for dietary long chain fatty acids improves body composition and lipid profile in a patient with human immunodeficiency virus lipodystrophy].
BACKGROUND
Lipodystrophy is a frequent disorder among patients with human immunodeficiency virus (HIV) infection, characterized by a loss of adipose tissue from the extremities, gluteal region and face, with excess fat in the neck and abdominal region. Metabolic abnormalities such as hyperlipidaemia and diabetes mellitus frequently coexist, posing these patients to an increased cardiovascular risk. Drug therapy may improve some of these metabolic disturbances, but to date there are no treatments for lipodystrophy with proven benefit.


METHODS
A 42-year-old man with HIV lipodystrophy was started on a standard low caloric diet with <30% of total fat and <10% of saturated fat, together with rosiglitazone 8 mg daily. After five months of treatment, given that lipodystrophic features and dyslipidaemia were still present in our patient, we tried to further improve therapeutic results by eucaloric substitution of medium chain triglycerides for dietary long chain fatty acids. Three months later, a dramatic change in body composition was shown with an increase in lean mass and a decrease in fat mass, together with an improvement in lipid profile.


CONCLUSIONS
Eucaloric substitution of medium chain triglycerides for dietary long chain fatty acids may produce therapeutic benefits in HIV lipodystrophy.
Vázquez
C
C
Servicio de Nutrición Clínica y Dietética, Hospital Ramón y Cajal, Madrid, España.
Reyes
R
R
Alcaraz
F
F
Balsa
J A
JA
Botella-Carretero
J I
JI
D000328:Adult; D001823:Body Composition; D004041:Dietary Fats / Q000008:administration & dosage*; D050171:Dyslipidemias / Q000178:diet therapy; D002149:Energy Intake; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D039682:HIV-Associated Lipodystrophy Syndrome / Q000178:diet therapy* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage
D004041:Dietary Fats; D005231:Fatty Acids, Unsaturated; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D014280:Triglycerides; D000077154:Rosiglitazone