Dreezen C, Schrooten W, de Mey I, Goebel F D, Dedes N, Florence E, Colebunders R
Institute of Tropical Medicine, Antwerpen, Belgium.
Int J STD AIDS. 2002 Jun;13(6):393-8. doi: 10.1258/095646202760029813.
To identify risk factors for the development of lipodystrophy in HIV infected patients on highly active antiretroviral therapy.
A survey among patients with HIV infection using an anonymous questionnaire was conducted in 10 European countries between December 1998 and December 1999. Nine hundred and four people receiving antiretrovirals, were included in the analyses.
368 (41%) people reported an increase in abdominal girth since commencing current antiretroviral treatment. Breast enlargement was reported by 106 people (12%). Lipoatrophy signs were reported by approximately one-third of the people: 291 (32%) complained about decrease in facial fat and 300 (33%) reported decrease in buttock fat. One hundred and thirty-one (15%) people reported both lipoatrophy signs and an increase in abdominal girth (mixed lipodystrophy syndrome). In multivariate analysis, the development of the mixed lipodystrophy syndrome was associated with a longer use of indinavir (OR=1.03, 95% CI: 1.00-1.06), ritonavir (OR=1.06, 1.02-1.09) and stavudine (OR=1.05, 1.02-1.08) and also with age, a longer duration of HIV seropositivity and an advanced stage of HIV infection.
This study suggests that multiple factors are associated with the occurrence of lipodystrophy, including the prolonged use of protease inhibitors.
确定接受高效抗逆转录病毒治疗的HIV感染患者发生脂肪代谢障碍的危险因素。
1998年12月至1999年12月期间，在10个欧洲国家对HIV感染患者进行了一项使用匿名问卷的调查。904名接受抗逆转录病毒治疗的患者纳入分析。
368人（41%）报告自开始当前抗逆转录病毒治疗以来腹围增加。106人（12%）报告有乳房增大。约三分之一的人报告有脂肪萎缩迹象：291人（32%）抱怨面部脂肪减少，300人（33%）报告臀部脂肪减少。131人（15%）报告既有脂肪萎缩迹象又有腹围增加（混合性脂肪代谢障碍综合征）。多因素分析显示，混合性脂肪代谢障碍综合征的发生与茚地那韦（OR=1.03，95%CI：1.00-1.06）、利托那韦（OR=1.06，1.02-1.09）和司他夫定（OR=1.05，1.02-1.08）的较长使用时间有关，还与年龄、HIV血清阳性持续时间较长以及HIV感染晚期有关。
本研究表明，多种因素与脂肪代谢障碍的发生有关，包括蛋白酶抑制剂的长期使用。
