Grima P F, Chiavaroli R, Grima P
Operative Unit of Infectious Diseases, S. Caterina Novella's Hospital, Via Roma 1, 73013, Galatina, Lecce, Italy.
Radiol Med. 2009 Feb;114(1):141-51. doi: 10.1007/s11547-008-0333-y. Epub 2008 Oct 25.
We performed a cross-sectional study of physical changes in HIV-infected adults to evaluate the role of ultrasonography for the diagnosis of lipodystrophy.
Sixty HIV-infected patients were recruited from 1 June to 31 December 2006. A total of 34 patients were included in the lipodystrophy group and 26 in no lipodystrophy group. Thickness of subcutaneous fat was measured twice with a high-frequency (15 MHz) transducer by transverse scans at four skin-based reference points: the periumbilical region, the brachial region, the crural region and the malar region. Visceral fat thickness was determined with a low-frequency (3.75 MHz) transducer at two skin reference points: perirenal fat diameter and visceral abdominal fat.
Compared with HIV-infected patients without lipodystrophy, those with lipoatrophy or mixed lipodystrophy had thinner facial, arm and leg fat, whereas patients with lipodystrophy showed thicker intra-abdominal fat. The median of the ratio between intra-abdominal fat and subcutaneous fat and between perirenal fat diameter and body mass index in the lipodystrophy group was higher than in the no lipodystrophy group. The measurements of brachial, malar and crural fat were significantly lower in patients with lipodystrophy.
We consider the ratio between visceral adipose tissue and subcutaneous adipose tissue and the thickness of malar fat to be the most useful ultrasonographic parameters for the early diagnosis of lipodystrophy in HIV-infected patients on highly active antiretroviral therapy.
我们对感染人类免疫缺陷病毒（HIV）的成年人的身体变化进行了一项横断面研究，以评估超声检查在脂肪代谢障碍诊断中的作用。
2006年6月1日至12月31日招募了60例HIV感染患者。脂肪代谢障碍组共纳入34例患者，非脂肪代谢障碍组纳入26例患者。使用高频（15兆赫）换能器在四个基于皮肤的参考点进行横向扫描，对皮下脂肪厚度进行两次测量：脐周区域、肱部区域、小腿区域和颊部区域。使用低频（3.75兆赫）换能器在两个皮肤参考点测定内脏脂肪厚度：肾周脂肪直径和腹部内脏脂肪。
与未患脂肪代谢障碍的HIV感染患者相比，患有脂肪萎缩或混合性脂肪代谢障碍的患者面部、手臂和腿部脂肪较薄，而患有脂肪代谢障碍的患者腹部内脂肪较厚。脂肪代谢障碍组腹部内脂肪与皮下脂肪之比以及肾周脂肪直径与体重指数之比的中位数高于非脂肪代谢障碍组。脂肪代谢障碍患者的肱部、颊部和小腿脂肪测量值显著较低。
我们认为内脏脂肪组织与皮下脂肪组织之比以及颊部脂肪厚度是对接受高效抗逆转录病毒治疗的HIV感染患者脂肪代谢障碍进行早期诊断最有用的超声参数。
