Association between physical and echographic fat thickness assessments and a lipodystrophy grading scale in lipodystrophic HIV patients: practical implications.
A simple diagnostic method for detecting in clinical routine HAART-associated lipodystrophy in HIV-infected patients is lacking. We studied the relationships between the scores obtained with a subjective lipodystrophy severity grading scale (LSGS) and standard anthropometric and echographic measurements of the subcutaneous and visceral fat thickness of 74 HIV-infected patients. Patients were divided into four groups according to their LSGS score (0, 1-7, 8-14, 15-21). Significant correlations between the LSGS and the anthropometric and echographic measurements of fat thickness, mainly the limb circumferences (brachial: r= -0.43, p < 0.001; thigh: r= -0.41, p < 0.001), and, especially, the echographically assessed perirenal fat diameters either adjusted (r= 0.46, p < 0.001) or nonadjusted to the body mass index (r= 0.35, p < 0.001) were observed. Significant differences in most of these anthropometric parameters between either the lowest (score 0) and the highest (score 15-21) score groups and the remaining groups were found, but not between the two intermediate groups (scores 1-7 vs. 8-14). This suggests that lipodystrophy should be clinically categorized as absent, mild, or marked, and that even minor changes in physical aspect should be considered as indicative of this disorder. The combination of these subjective and objective parameters could be helpful in the early detection of lipodystrophy in clinical practice.
Asensi
Victor
V
Infectious Diseases Unit, Hospital Central de Asturias, Oviedo University School of Medicine, Barcelona, Spain. vasensia@medynet.com
Martín-Roces
Eustaquio
E
Collazos
Julio
J
Cartón
José A
JA
Maradona
José A
JA
Alonso
Angeles
A
Medina
Marifé
M
Aburto
Jesús M
JM
Fernández
Cristina
C
Martínez
Esteban
E
D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000886:Anthropometry / Q000379:methods*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D050218:Body Fat Distribution / Q000145:classification; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000145:classification* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods