Yang Yong, Yap Marline, Oo Tha Naing, Paton Nicholas I
Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
HIV Clin Trials. 2008 Nov-Dec;9(6):399-406. doi: 10.1310/hct0906-399.
An objective method is needed for assessing facial fat changes in HIV-infected patients.
To measure facial fat changes using three-dimensional laser scans (LS) and examine the relationship with clinically assessed lipoatrophy changes and dual-energy X-ray absorptiometry (DEXA) measured body composition changes in a cohort of patients taking combination antiretroviral therapy (ART).
Consecutive patients taking ART for at least 12 months were recruited from an outpatient clinic. Clinical lipoatrophy assessment, LS of the face, and whole-body DEXA were performed at baseline and repeated after 12 months. Cheek surface volume (CSV) change and cheek surface point displacement (CPD) change were calculated from the LS using a standardized technique.
Baseline and follow-up assessments were obtained in 146 patients. In the 102 patients with stable clinical lipoatrophy grade during follow-up, there was no CSV change (0.0 +/- 1.7 mL). In the 27 patients with clinical lipoatrophy progression, CSV decreased by 1.3 +/- 1.8 mL (p < .001 vs. stable patients); in the 17 patients with clinical facial lipoatrophy recovery, CSV increased by 1.0 +/- 1.7 mL (p = .092 vs. stable patients). CSV change was significantly related to limb fat change in the overall cohort (r = 0.32, p < .001). Multivariate regression analysis showed that stavudine use was a significant independent predictor of CSV (beta = -0.20, p = .038). Similar results were seen with calculation of CPD change.
LS can detect facial lipoatrophy changes in a cohort of patients over time and can clearly detect the effects of individual drugs. This may be an objective and reliable method to assess facial fat change in future clinical trials.
需要一种客观的方法来评估HIV感染患者面部脂肪的变化。
使用三维激光扫描（LS）测量面部脂肪变化，并在一组接受联合抗逆转录病毒治疗（ART）的患者中，研究其与临床评估的脂肪萎缩变化以及双能X线吸收法（DEXA）测量的身体成分变化之间的关系。
从门诊招募连续接受ART至少12个月的患者。在基线时进行临床脂肪萎缩评估、面部LS和全身DEXA，并在12个月后重复进行。使用标准化技术从LS计算脸颊表面体积（CSV）变化和脸颊表面点位移（CPD）变化。
146例患者获得了基线和随访评估。在随访期间临床脂肪萎缩分级稳定的102例患者中，CSV无变化（0.0±1.7 mL）。在27例临床脂肪萎缩进展的患者中，CSV下降了1.3±1.8 mL（与稳定患者相比，p<.001）；在17例临床面部脂肪萎缩恢复的患者中，CSV增加了1.0±1.7 mL（与稳定患者相比，p=.092）。在整个队列中，CSV变化与肢体脂肪变化显著相关（r=\(0.32\)，p<.001）。多变量回归分析显示，使用司他夫定是CSV的显著独立预测因素（β=-\(0.20\)，p=\(0.038\)）。计算CPD变化时也观察到类似结果。
LS可以随时间检测一组患者的面部脂肪萎缩变化，并能清楚地检测个别药物的效果。这可能是未来临床试验中评估面部脂肪变化的一种客观可靠的方法。
