Engelson E S, Kotler D P, Tan Y, Agin D, Wang J, Pierson R N, Heymsfield S B
Gastrointestinal Division, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Am J Clin Nutr. 1999 Jun;69(6):1162-9. doi: 10.1093/ajcn/69.6.1162.
Antiretroviral therapy has improved the prospects for people infected with HIV, but some develop a syndrome of profound body habitus and metabolic alterations that include truncal enlargement.
The purpose of this study was to define the body-composition changes associated with this syndrome by using techniques with the power to estimate regional body composition.
We compared whole-body and regional skeletal muscle and adipose tissue contents measured by magnetic resonance imaging and dual-energy X-ray absorptiometry (DXA) in 26 HIV-infected patients and 26 matched control subjects. Twelve of the HIV-infected patients had evidence of truncal enlargement.
HIV-infected men and women who noted truncal enlargement had similar amounts of skeletal muscle and subcutaneous adipose tissue but greater visceral adipose tissue than HIV-infected patients without truncal enlargement; these values were larger in men (P < 0.001) than in women (P = 0.08). The ratio of visceral to subcutaneous adipose tissue was greater in both men (P < 0.02) and women (P = 0.05) with truncal enlargement. Two subjects with MRI-confirmed visceral adiposity syndrome (VAS) were not taking protease inhibitors. CD4+ lymphocyte counts were higher (P < 0.001) and plasma viral burdens tended to be lower (P = 0.08) in HIV-infected patients with VAS.
There was significantly more visceral adipose tissue in the subgroup of HIV-infected patients with truncal enlargement than in those without this sign. VAS occurs in both men and women, is associated with higher CD4+ lymphocyte counts and lower plasma HIV viral burdens, and is not limited to those receiving protease inhibitor therapy.
抗逆转录病毒疗法改善了人类免疫缺陷病毒（HIV）感染者的预后，但一些患者会出现严重的身体形态和代谢改变综合征，包括躯干增粗。
本研究旨在通过使用能够估计局部身体成分的技术来确定与该综合征相关的身体成分变化。
我们比较了26例HIV感染患者和26例匹配的对照受试者通过磁共振成像和双能X线吸收法（DXA）测量的全身及局部骨骼肌和脂肪组织含量。12例HIV感染患者有躯干增粗的证据。
有躯干增粗的HIV感染男性和女性的骨骼肌和皮下脂肪组织量相似，但内脏脂肪组织比无躯干增粗的HIV感染患者更多；这些值在男性中（P < 0.001）比在女性中（P = 0.08）更大。有躯干增粗的男性（P < 0.02）和女性（P = 0.05）的内脏与皮下脂肪组织比值更高。两名经磁共振成像证实有内脏肥胖综合征（VAS）的受试者未服用蛋白酶抑制剂。有VAS的HIV感染患者的CD4 +淋巴细胞计数更高（P < 0.001），血浆病毒载量往往更低（P = 0.08）。
有躯干增粗的HIV感染患者亚组中的内脏脂肪组织明显多于无此体征的患者。VAS在男性和女性中均有发生，与较高的CD4 +淋巴细胞计数和较低的血浆HIV病毒载量相关，且不限于接受蛋白酶抑制剂治疗的患者。
