Lipodystrophy, lipid profile changes, and low serum retinol and carotenoid levels in children and adolescents with acquired immunodeficiency syndrome.
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.
Battistini
Tânia Regina Beraldo
TR
Department of Pediatrics, ABC School of Medicine, São Paulo, Brazil.
Sarni
Roseli Oselka Saccardo
RO
de Souza
Fabíola Isabel Suano
FI
Pitta
Tassiana Sacchi
TS
Fernandes
Ana Paula
AP
Hix
Sonia
S
Fonseca
Fernando Luiz Affonso
FL
Tardini
Priscila Chemiotti
PC
dos Santos
Valter Pinho
VP
Lopez
Fábio Ancona
FA
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
D044966:Anti-Retroviral Agents; D001786:Blood Glucose; D019207:beta Carotene; D014801:Vitamin A