title: Lipodystrophy, lipid profile changes, and low serum retinol and carotenoid levels in children and adolescents with acquired immunodeficiency syndrome.
abstract: OBJECTIVE
  To assess serum retinol and levels of carotenoids in children and adolescents with acquired immunodeficiency syndrome (AIDS) and to correlate low serum retinol and carotenoid levels with the presence of lipodystrophy, lipid profile changes, lipid peroxidation, and insulin resistance.
  
  
  METHODS
  A cross-sectional, controlled observational study was carried out with 30 children and adolescents with AIDS (mean age 9.1 y) receiving antiretroviral therapy (median length of treatment 28.4 mo), including 30 uninfected healthy controls matched for age and gender. Clinical and laboratory assessments were performed to determine nutritional status, presence of lipodystrophy, serum concentrations of retinol, beta-carotene, lycopene, lipid profile (high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols), lipid peroxidation (thiobarbituric acid-reactive substances), glycemia, and serum insulin (homeostasis model assessment for insulin resistance, cutoff point >3). Statistical analysis was done with chi-square test and Student's t test.
  
  
  RESULTS
  Lipodystrophy was observed in 53.3% of patients with AIDS, and dyslipidemia was detected in 60% and 23% of subjects with human immunodeficiency virus and control subjects, respectively (P = 0.004). A higher prevalence of retinol deficiency (60% versus 26.7%, P = 0.009) and beta-carotene deficiency (23.3% versus 3.3%, P = 0.026) was found in the group with human immunodeficiency virus than in the control group. No correlation was found for low retinol and beta-carotene levels, changes in lipid and glucose metabolism, or lipodystrophy in children and adolescents with AIDS.
  
  
  CONCLUSIONS
  Despite the high frequency of dyslipidemia, lipodystrophy, and retinol and beta-carotene deficiencies, it was not possible to demonstrate a correlation of these findings with lipid peroxidation and insulin resistance. More studies are needed to investigate the causes of retinol and beta-carotene deficiencies in this population and the clinical consequences of these findings.
authors.affiliation: Department of Pediatrics, ABC School of Medicine, São Paulo, Brazil.
authors.forename: Tânia Regina Beraldo
authors.initials: TR
authors.lastname: Battistini
authors.forename: Roseli Oselka Saccardo
authors.initials: RO
authors.lastname: Sarni
authors.forename: Fabíola Isabel Suano
authors.initials: FI
authors.lastname: de Souza
authors.forename: Tassiana Sacchi
authors.initials: TS
authors.lastname: Pitta
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Fernandes
authors.forename: Sonia
authors.initials: S
authors.lastname: Hix
authors.forename: Fernando Luiz Affonso
authors.initials: FL
authors.lastname: Fonseca
authors.forename: Priscila Chemiotti
authors.initials: PC
authors.lastname: Tardini
authors.forename: Valter Pinho
authors.initials: VP
authors.lastname: dos Santos
authors.forename: Fábio Ancona
authors.initials: FA
authors.lastname: Lopez
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000150:complications / Q000821:virology; D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000009:adverse effects; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006678:HIV; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism; D015227:Lipid Peroxidation; D008297:Male; D018384:Oxidative Stress; D015995:Prevalence; D014801:Vitamin A / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications; D019207:beta Carotene / Q000097:blood* / Q000172:deficiency
chemical_list: D044966:Anti-Retroviral Agents; D001786:Blood Glucose; D019207:beta Carotene; D014801:Vitamin A