Desai Ninad, Mullen Patricia, Mathur Mudit
Kings County Hospital Center & SUNY-Downstate College of Medicine, Brooklyn, NY 11203, USA.
Indian J Pediatr. 2008 Apr;75(4):351-4. doi: 10.1007/s12098-008-0037-2. Epub 2008 May 18.
To assess fat accumulation in children with HIV/AIDS on long term HAART using CDC defined Body mass Index (BMI) criteria and measured Bioelectric Impedance (BI).
Prospective study of 48 HIV infected children (ages 6-15 years) on HAART to determine the incidence of lipodystrophy and evaluate methods of determining body fat accumulation. Lipodystrophy was diagnosed using clinical features-truncal obesity with facial/limb wasting. BMI (weight in kg/height in meters2) was plotted on CDC curves to predict the risk of obesity. BI was performed using Omron's HBF301 body fat analyzer and reported as TBF %/height. Serum cholesterol and triglycerides were measured. Results were compared using ANOVA RESULTS: Average duration of HAART was 2.4 years. Forty five of 48 patients were on protease inhibitors. Fifteen (31%) developed Lipodystrophy, but CDC BMI curves identify only 7/15 as overweight or at risk for obesity. However, TBF/Ht of 30% (using BI) was 85% sensitive and 88% specific in identifying Lipodystrophy. Hyperlipidemia occurred in 28/48 (58%) overall, in 14/15 (93%) diagnosed with lipodystrophy.
Lipodystrophy is a significant problem in children with HIV/AIDS on HAART. BI is more useful than BMI in identifying patients with abnormal fat accumulation and should be incorporated in their routine assessment in the ambulatory setting.
使用美国疾病控制与预防中心（CDC）定义的体重指数（BMI）标准和测量的生物电阻抗（BI）来评估接受长期高效抗逆转录病毒治疗（HAART）的HIV/AIDS儿童的脂肪堆积情况。
对48名接受HAART的HIV感染儿童（6 - 15岁）进行前瞻性研究，以确定脂肪代谢障碍的发生率，并评估确定身体脂肪堆积的方法。根据临床特征——躯干肥胖伴面部/肢体消瘦来诊断脂肪代谢障碍。将BMI（体重千克数/身高米数的平方）绘制在CDC曲线上以预测肥胖风险。使用欧姆龙HBF301体脂分析仪进行生物电阻抗测量，并报告为总体脂百分比/身高。测量血清胆固醇和甘油三酯。使用方差分析比较结果。
HAART的平均疗程为2.4年。48名患者中有45名正在使用蛋白酶抑制剂。15名（31%）出现脂肪代谢障碍，但CDC的BMI曲线仅将其中7/15识别为超重或有肥胖风险。然而，使用BI测得的总体脂百分比/身高为30%时，在识别脂肪代谢障碍方面的敏感性为85%，特异性为88%。总体上，28/48（58%）出现高脂血症，在诊断为脂肪代谢障碍的14/15（93%）患者中出现高脂血症。
脂肪代谢障碍是接受HAART的HIV/AIDS儿童中的一个重要问题。在识别脂肪堆积异常的患者方面，生物电阻抗比BMI更有用，应将其纳入门诊患者的常规评估中。
