title: Relationship Between Adiposity Indices, Lipodystrophy, and Sarcopenia in HIV-Positive Individuals With and Without Lipodystrophy.
abstract: Metabolism disorders, as well as body shape abnormalities, have been associated with the introduction of antiretroviral therapy. The objective of this study was to compare the diagnostic ability of adiposity indices and to discuss criteria for the classification of lipodystrophy and sarcopenia (SP) in HIV-positive individuals. Anthropometric measurements were determined in 268 individuals of both genders, also submitted to the dual-energy X-ray absorptiometry exam. The adiposity indices calculated were body mass index, body mass index adjusted for fat mass (BMIfat), body adiposity index, body adiposity Index for the Fels Longitudinal Study sample, and The Clínica Universidad de Navarra body adiposity estimator. The presence of lipodystrophy was evaluated using the fat mass ratio (FMR). SP was classified using the appendicular lean mass/height2ratio. The subjects were divided into 3 groups: HIV+LIPO+(n = 41), HIV+LIPO-(n = 65), and control (C, HIV-negative individuals; n = 162). Among the adiposity indices assessed, BMIfat showed the strongest correlation with total body fat (in percent) for men (r = 0.87, p < 0.001) and women (r = 0.92, p < 0.001). The frequency of SP was 44.8% and 41.7% in HIV+LIPO+, 27.8% and 20.7% in HIV+LIPO-and 63.3% and 45.45% in C, for men and women, respectively. The cutoff point suggested for the diagnosis of lipodystrophy according to the FMR was 1.14. The adiposity indices, particularly the BMIfat, have strong correlation with body fat determined by dual-energy X-ray absorptiometry in HIV-positive patients. The implementation of FMR is recommended for more standardized estimates of the frequency of lipodystrophy.
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil. Electronic address: mirele.mialich@usp.br.
authors.forename: Mirele Savegnago
authors.initials: MS
authors.lastname: Mialich
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
authors.forename: André Pereira
authors.initials: AP
authors.lastname: Dos Santos
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
authors.forename: Bruna Ramos
authors.initials: BR
authors.lastname: da Silva
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
authors.forename: Francisco José Albuquerque
authors.initials: FJ
authors.lastname: de Paula
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
authors.forename: Alceu Afonso
authors.initials: AA
authors.lastname: Jordão
authors.affiliation: Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
authors.forename: Anderson Marliere
authors.initials: AM
authors.lastname: Navarro
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D050218:Body Fat Distribution; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D055948:Sarcopenia / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Adiposity indices; highly active antiretroviral therapy (ART); human immunodeficiency virus (HIV); lipodystrophy; sarcopenia