title: [Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: relation with metabolic syndrome and cardiovascular risk factors].
abstract: Lipodystrophy in HIV-infected patients (LDHIV) affects 40-50% of HIV-infected patients, but there are no data on its prevalence in Brazil. The aim of this study was to assess the LDHIV prevalence among HIV-infected adult Brazilian individuals, as well as to evaluate LDHIV association with cardiovascular risk factors and the metabolic syndrome (MS). It was included 180 adult HIV-infected outpatients consecutively seen in the Infectology Clinic of Universidade Estadual de Londrina. Anthropometric and clinical data (blood pressure, family and personal comorbidities, duration of HIV infection/AIDS, antiretroviral drugs used, CD4+ cells, viral load, fasting glycemia and plasma lipids) were obtained both from a clinical interview as well as from medical charts. LDHIV was defined as the presence of body changes self-reported by the patients and confirmed by clinical exam. MS was defined using the NCEP-ATPIII criteria, reviewed and modified by AHA/NHLBI. A 55% prevalence of LDHIV was found. Individuals with LDHIV presented a longer infected period since HIV infection, longer AIDS duration and longer use of antiretroviral drugs. In multivariate analysis, women (p=0.006) and AIDS duration >8 years (p<0.001) were independently associated with LDHIV. Concerning MS diagnostic criteria, high blood pressure was found in 32%, low HDL-cholesterol in 68%, hypertriglyceridemia in 55%, altered waist circumference in 17% and altered glycemia and/or diabetes in 23% of individuals. Abnormal waist and hypertriglyceridemia were more common in LDHIV-affected individuals. MS was diagnosed in 36%. In multivariate analysis, the factors associated with MS were: BMI >25 kg/m(2) (p<0.001), family history of obesity (p=0.01), indinavir (p=0.001) and age >40 years on HIV first detection (p=0.002). There was a trend to higher frequency of LDHIV among patients with MS (65% versus 50%, p=0.051). LDHIV prevalence among our patients (55%) was similar to previous reports from other countries. MS prevalence in these HIV-infected individuals seems to be similar to the prevalence reported on Brazilian non-HIV-infected adults.
authors.affiliation: Centro de Ciências, Departamento de Clínica Médica da Saúde, Universidade Estadual de Londrina, PR, Brasil. leandro@portalendocrino.com.br
authors.forename: Leandro A
authors.initials: LA
authors.lastname: Diehl
authors.forename: Janaína R
authors.initials: JR
authors.lastname: Dias
authors.forename: Aline C S
authors.initials: AC
authors.lastname: Paes
authors.forename: Maria C
authors.initials: MC
authors.lastname: Thomazini
authors.forename: Lorena R
authors.initials: LR
authors.lastname: Garcia
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cinagawa
authors.forename: Susana L
authors.initials: SL
authors.lastname: Wiechmann
authors.forename: Alexandre J F
authors.initials: AJ
authors.lastname: Carrilho
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D010045:Outpatients; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D019380:Anti-HIV Agents