Yang Yong, Sitoh Yih-Yian, Oo Tha Naing, Paton Nicholas I
Infectious Disease Research Centre, Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
Antivir Ther. 2005;10(4):575-81.
The volume and anatomical distribution of facial fat depletion in HIV related lipoatrophy have not been properly quantified. We aimed to determine the extent and distribution of facial fat loss in HIV-infected patients with lipoatrophy and whether this differs from wasting.
We studied HIV-infected patients with clinically defined moderate to severe lipoatrophy without wasting (n = 15), clinically defined wasting (> 10% weight loss and recent opportunistic infection) with no previous reported lipodystrophy (n = 15), and controls without lipodystrophy or wasting (n = 15). Facial MRI scans were performed, and areas of fat were manually traced bilaterally in all individual image slices and summed to calculate volume in anatomically defined regions of interest.
Patients with lipoatrophy had lower fat volumes in the temporal region (8.9 +/- 9.4 vs 20.5 +/- 7.2 ml; P < 0.001), cheek region (25.6 +/- 24.9 vs 55.5 +/- 15.0 ml; P < 0.001), periorbital region (1.9 +/- 1.0 vs 2.7 +/- 1.0 ml; P = 0.09) and buccal fat pad (13.4 +/- 9.4 vs 21.8 +/- 9.8 ml; P = 0.030) compared with controls. Patients with wasting had temporal, cheek, periorbital and buccal fat pad volumes (10.4 +/- 6.7 ml, 34.0 +/- 14.8 ml, 1.4 +/- 1.1 ml and 13.1 +/- 4.6 ml respectively) that were lower than controls (all P < 0.01) but similar to lipoatrophy patients (all P > 0.5).
Facial fat depletion in lipoatrophy is substantial (approximately 50% volume loss) and involves superficial and deep fat (buccal fat pad). The distribution and volume of fat change is similar to that seen in wasting. Given the extent of the changes, complete surgical correction is unlikely to be possible and hence emphasis should be placed on prevention of lipoatrophy [corrected]
在与HIV相关的脂肪萎缩中，面部脂肪消耗的体积和解剖分布尚未得到恰当量化。我们旨在确定HIV感染的脂肪萎缩患者面部脂肪流失的程度和分布情况，以及这是否与消瘦有所不同。
我们研究了临床上定义为中度至重度脂肪萎缩但无消瘦的HIV感染患者（n = 15）、临床上定义为消瘦（体重减轻> 10%且近期有机会性感染）且既往无脂肪代谢障碍报告的患者（n = 15），以及无脂肪代谢障碍或消瘦的对照组（n = 15）。进行了面部MRI扫描，并在所有单独的图像切片上双侧手动描绘脂肪区域，然后求和以计算解剖学定义感兴趣区域的体积。
与对照组相比，脂肪萎缩患者颞部区域的脂肪体积较低（8.9±9.4 vs 20.5±7.2 ml；P < 0.001）、颊部区域（25.6±24.9 vs 55.5±15.0 ml；P < 0.001）、眶周区域（1.9±1.0 vs 2.7±1.0 ml；P = 0.09）和颊脂垫（13.4±9.4 vs 21.8±9.8 ml；P = 0.030）。消瘦患者的颞部、颊部、眶周和颊脂垫体积（分别为10.4±6.7 ml、34.0±14.8 ml、1.4±1.1 ml和13.1±4.6 ml）低于对照组（所有P < 0.01），但与脂肪萎缩患者相似（所有P > 0.5）。
脂肪萎缩中的面部脂肪消耗显著（体积损失约50%），且涉及浅表和深部脂肪（颊脂垫）。脂肪变化的分布和体积与消瘦所见相似。鉴于变化程度，完全手术矫正不太可能实现，因此应强调预防脂肪萎缩[已修正]
