Bacchetti Peter, Gripshover Barbara, Grunfeld Carl, Heymsfield Steven, McCreath Heather, Osmond Dennis, Saag Michael, Scherzer Rebecca, Shlipak Michael, Tien Phyllis
University of California, San Francisco Veterans Affairs Medical Center, Metabolism Section, 94121, USA.
J Acquir Immune Defic Syndr. 2005 Oct 1;40(2):121-31. doi: 10.1097/01.qai.0000182230.47819.aa.
Both peripheral fat loss and central fat gain have been reported in HIV infection. Which changes are specific to HIV were determined by comparison with control subjects and the associations among different adipose tissue depots were determined.
Cross-sectional analysis of HIV-positive and control men from the study of Fat Redistribution and Metabolic Change in HIV Infection. Lipoatrophy or lipohypertrophy was defined as concordance between participant report of change and examination. Regional adipose tissue volume was measured by magnetic resonance imaging (MRI).
HIV-positive men reported more fat loss than controls in all peripheral and most central depots. Peripheral lipoatrophy was more frequent in HIV-positive men than in controls (38.3% vs. 4.6%, P < 0.001), whereas central lipohypertrophy was less frequent (40.2% vs. 55.9%, P = 0.001). Among HIV-positive men, the presence of central lipohypertrophy was not positively associated with peripheral lipoatrophy (odds ratio = 0.71, CI: 0.47 to 1.06, P = 0.10). On MRI, HIV-positive men with clinical peripheral lipoatrophy had less subcutaneous adipose tissue (SAT) in peripheral and central sites and less visceral adipose tissue (VAT) than HIV-positive men without peripheral lipoatrophy. HIV-positive men both with and without lipoatrophy had less SAT than controls, with legs and lower trunk more affected than upper trunk. Use of the antiretroviral drugs stavudine or indinavir was associated with less leg SAT but did not appear to be associated with more VAT; nevirapine use was associated with less VAT.
Both peripheral and central subcutaneous lipoatrophy was found in HIV infection. Lipoatrophy in HIV-positive men is not associated with reciprocally increased VAT.
据报道，HIV感染患者存在外周脂肪减少和中心性脂肪增加的情况。通过与对照受试者比较来确定哪些变化是HIV感染所特有的，并确定不同脂肪组织储存部位之间的关联。
对HIV感染患者脂肪重新分布和代谢变化研究中的HIV阳性男性和对照男性进行横断面分析。脂肪萎缩或脂肪肥大定义为参与者报告的变化与检查结果一致。通过磁共振成像（MRI）测量局部脂肪组织体积。
HIV阳性男性报告在所有外周和大多数中心部位的脂肪减少均多于对照。HIV阳性男性外周脂肪萎缩比对照更常见（38.3%对4.6%，P<0.001），而中心性脂肪肥大则较少见（40.2%对55.9%，P = 0.001）。在HIV阳性男性中，中心性脂肪肥大的存在与外周脂肪萎缩无正相关（优势比=0.71，CI：0.47至1.06，P = 0.10）。在MRI上，有临床外周脂肪萎缩的HIV阳性男性在外周和中心部位的皮下脂肪组织（SAT）及内脏脂肪组织（VAT）均少于无外周脂肪萎缩的HIV阳性男性。有和无脂肪萎缩的HIV阳性男性的SAT均少于对照，腿部和下躯干比上躯干受影响更严重。使用抗逆转录病毒药物司他夫定或茚地那韦与腿部SAT减少有关，但似乎与VAT增加无关；使用奈韦拉平与VAT减少有关。
HIV感染患者存在外周和中心性皮下脂肪萎缩。HIV阳性男性的脂肪萎缩与VAT的相应增加无关。
