HIV 阳性脂肪营养不良患者在一年随访期间的营养和代谢状况。
Nutritional and metabolic status of HIV-positive patients with lipodystrophy during one year of follow-up.
机构信息
Department of Pediatrics, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
出版信息
Clinics (Sao Paulo). 2011;66(3):407-10. doi: 10.1590/s1807-59322011000300007.
OBJECTIVES
The aim of this prospective study was to compare changes in lipid metabolism and nutritional status after either 6 and 12 months of follow-up in subjects with lipodystrophy syndrome after traditional lifestyle therapy with or without fibric acid analogue intervention (bezafibrate and clofibrate).
METHODS
Food intake, alterations in body composition and metabolic abnormalities were assessed in subjects with lipodystrophy syndrome at the beginning of the study. The nutritional status and metabolic alterations of the subjects were monitored, and the subjects received nutritional counseling each time they were seen. The subjects were monitored either two times over a period no longer than six months (Group A; n = 18) or three times over a period of at least 12 months (Group B; n = 35). All of the subjects underwent nutrition counseling that was based on behavior modification. The fibric acid analogue was only given to patients with serum triglyceride levels above 400 mg/dL.
RESULTS
After six months of follow-up, Group A showed no alterations in the experimental parameters. After twelve months, there was a decrease in serum triglyceride levels (410.4 ± 235.5 vs. 307.7 ± 150.5 mg/dL, p < 0.05) and an increase in both HDLc levels (37.9 ± 36.6 vs. 44.9 ± 27.9 mg/dL, p,0.05) and lean mass (79.9 ± 7.8 vs. 80.3 ± 9.9 %, p < 0.05) in Group B.
CONCLUSION
After one year of follow-up (three sessions of nutritional and medical counseling), the metabolic parameters of the subjects with lipodystrophy improved after traditional lifestyle therapy with or without fibric acid analogue intervention.
目的
本前瞻性研究旨在比较传统生活方式治疗加或不加纤维酸类似物（苯扎贝特和氯贝特）干预后脂肪营养不良综合征患者经过 6 个月和 12 个月随访后脂代谢和营养状况的变化。
方法
在研究开始时评估脂肪营养不良综合征患者的饮食摄入、身体成分变化和代谢异常。监测患者的营养状况和代谢变化，每次就诊时都提供营养咨询。患者监测时间分别为不超过 6 个月（A 组，n = 18）或至少 12 个月（B 组，n = 35）。所有患者均接受基于行为改变的营养咨询。仅对血清甘油三酯水平高于 400mg/dL 的患者给予纤维酸类似物。
结果
A 组在 6 个月的随访后，实验参数无变化。12 个月后，血清甘油三酯水平下降（410.4 ± 235.5 比 307.7 ± 150.5mg/dL，p < 0.05），高密度脂蛋白胆固醇水平升高（37.9 ± 36.6 比 44.9 ± 27.9mg/dL，p < 0.05），瘦体重增加（79.9 ± 7.8 比 80.3 ± 9.9%，p < 0.05）。
结论
经过 1 年的随访（3 次营养和医疗咨询），传统生活方式治疗加或不加纤维酸类似物干预后脂肪营养不良综合征患者的代谢参数得到改善。
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