title: How much fat loss is needed for lipoatrophy to become clinically evident?
abstract: The objective of this study was to evaluate how much limb fat is needed to be lost for lipoatrophy to become clinically evident. Antiretroviral drug-naive patients from a randomized trial comparing stavudine or abacavir plus lamivudine and efavirenz, who had subjective assessment to detect clinically evident lipoatrophy (standardized questionnaire) and objective measurements of limb fat (dual X-ray absorptiometry) at baseline, 48 weeks, and 96 weeks were included. ROC curves were used to assess the sensitivity and specificity of several cut-off values of absolute and percent limb fat loss for diagnosing lipoatrophy. Of 54 patients included, 13 (24%) had subjective lipoatrophy at 96 weeks. After 96 weeks, median limb fat change was -2.3 kg (interquartile range: -5.2, +0.2) and 0.4 kg (interquartile range: -7.2, +3.4) in patients with and without lipoatrophy, respectively. Median percent limb fat change was -45.5% (interquartile range: -78.0, +3.7) and 5.5% (interquartile range: -62.8, +95.6), respectively. The cut-off values of absolute and percent limb fat loss showing the best sensitivity and specificity values were -1.5 kg (sensitivity, 77%; specificity, 76%) and -30% (sensitivity, 85%; specificity, 73%). At least 30% limb fat is needed to be lost in HIV-infected patients for lipoatrophy to become clinically evident.
authors.affiliation: Infectious Disease Service, Hospital Universitari de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, Barcelona 08907, Spain. dpodzamczer@csub.scs.es
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
authors.forename: Elena
authors.initials: E
authors.lastname: Ferrer
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
authors.forename: Luis
authors.initials: L
authors.lastname: Del Rio
authors.forename: Joaquín
authors.initials: J
authors.lastname: Rosales
authors.forename: Jordi
authors.initials: J
authors.lastname: Curto
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.forename: Pilar
authors.initials: P
authors.lastname: Barrufet
authors.forename: Josep M
authors.initials: JM
authors.lastname: Llibre
authors.forename: Miquel
authors.initials: M
authors.lastname: Aranda
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000473:pathology*; D000328:Adult; D000818:Animals; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents