Guaraldi Giovanni, Murri Rita, Orlando Gabriella, Giovanardi Chiara, Squillace Nicola, Vandelli Marcella, Beghetto Barbara, Nardini Giulia, De Paola Maria, Esposito Roberto, Wu Albert W
Department of Medicine and Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.
AIDS Patient Care STDS. 2008 Jul;22(7):577-85. doi: 10.1089/apc.2007.0173.
The impact of lipodystrophy (LD) on quality of life is high, but it has not been demonstrated in literature. The objective of the study was to assess the impact of LD on the health-related quality of life (HRQOL) in HIV-infected people on highly active antiretroviral therapy (HAART). Patients with LD phenotype defined by the Multicenter AIDS Cohort Study (MACS) were included. Three different methods were used to define LD severity: both patient and physician evaluation using the HIV Outpatient Study (HOPS) severity scales and the Lipodystrophy Case Definition (LDCD). The HRQOL was evaluated by MOS-HIV Health Survey. Four hundred one patients on HAART for a mean of 108 +/- 52 months were evaluated for LD at the Metabolic Clinic of Modena and Reggio Emilia University were enrolled from January 2003 to July 2006. According to self-perceived or physician-based HOPS, 106 (26.5%) and 122 (30.4%) patients had severe LD. Females had significantly more severe LD. Few HRQOL scores correlated to LD severity using the physician-based score (both HOPSph and LDCD), while all the HRQOL scores correlated with LD severity when a patient-based score was used (HOPSpt). In multiple linear regression analysis, Mental Health HRQOL score, gender, body mass index, age, body image satisfaction were independent predictors of patient-based (HOPSpt) LD, while none of the HRQOL scores, but female gender, age, waist-to-hip ratio, limb fat, and body image satisfaction were correlated with physician-estimated HOPSph LD severity. HRQOL was strongly correlated with LD severity when a patient-based score was used. For an overall assessment of the impact of LD on HIV-infected people, both patient-based and physician-based measures are required.
脂肪代谢障碍（LD）对生活质量的影响很大，但尚未在文献中得到证实。本研究的目的是评估LD对接受高效抗逆转录病毒治疗（HAART）的HIV感染者健康相关生活质量（HRQOL）的影响。纳入了由多中心艾滋病队列研究（MACS）定义的LD表型患者。使用三种不同方法定义LD严重程度：患者和医生均使用HIV门诊研究（HOPS）严重程度量表以及脂肪代谢障碍病例定义（LDCD）进行评估。通过MOS-HIV健康调查评估HRQOL。2003年1月至2006年7月，在摩德纳和雷焦艾米利亚大学代谢诊所对401名平均接受HAART治疗108±52个月的患者进行了LD评估。根据自我感知或基于医生的HOPS评估，106名（26.5%）和122名（30.4%）患者有严重LD。女性的LD严重程度明显更高。使用基于医生的评分（HOPSph和LDCD）时，很少有HRQOL评分与LD严重程度相关，而使用基于患者的评分（HOPSpt）时，所有HRQOL评分均与LD严重程度相关。在多元线性回归分析中，心理健康HRQOL评分、性别、体重指数、年龄、身体形象满意度是基于患者的（HOPSpt）LD的独立预测因素，而没有HRQOL评分，但女性性别、年龄、腰臀比、肢体脂肪和身体形象满意度与医生评估的HOPSph LD严重程度相关。使用基于患者的评分时，HRQOL与LD严重程度密切相关。为了全面评估LD对HIV感染者的影响，需要基于患者和基于医生的测量方法。
