Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.
Braz J Infect Dis. 2013 Jan-Feb;17(1):1-6. doi: 10.1016/j.bjid.2012.12.001. Epub 2013 Jan 11.
To identify lipodystrophy in prepubertal HIV-infected children using anthropometric parameters and body composition assessment.
Cross-sectional study including 40 prepubertal HIV-infected children of both genders seen at the Care Center of the Division of Pediatric Infectious Diseases - Universidade Federal de São Paulo, São Paulo city, Brazil, was carried out from August to December 2008. Age, clinical and immunological status, prophylaxis, transmission and highly active antiretroviral therapy were recorded. Body mass index z-score and height-for-age z-score were calculated to characterize the nutritional status. Circumferences were measured with flexible tape and skinfolds were assessed by an adipometry. Fat mass and lean mass were determined by dual-energy X-ray absorptiometry. Presence of clinical signs of lipodystrophy was assessed by a trained clinician. Data were analyzed using SPSS 12.0 software.
The mean age and standard deviation were 9.8 (1.2) years, 50% were girls and 82.5% children from B and C categories. Clinical lipodystrophy and dislypidemia were present in 27.5% and 70%, respectively. The trunk to arm ratio and the limb to trunk ratio had positive association with lipodystrophy. Patients with lipodystrophy had short stature, higher triglycerides values and lower HDL-cholesterol.
The ratios obtained by skinfolds and dual-energy X-ray absorptiometry measurements can be considered as indicators of preclinical lipodystrophy. The cutoff points have not been determined yet; however, continuous assessment may be useful to identify early body composition changes.
利用人体测量参数和身体成分评估来识别青春期前感染 HIV 的儿童的脂代谢障碍。
本横断面研究纳入了 2008 年 8 月至 12 月期间在巴西圣保罗联邦大学小儿传染病科关怀中心就诊的 40 名青春期前感染 HIV 的儿童，这些儿童为两性。记录了年龄、临床和免疫状态、预防措施、传播途径和高效抗逆转录病毒治疗情况。通过计算体重指数 z 评分和身高年龄 z 评分来描述营养状况。使用柔性卷尺测量周长，通过人体脂肪测量仪评估皮褶厚度。通过双能 X 射线吸收仪确定脂肪量和瘦体量。由经过培训的临床医生评估脂代谢障碍的临床体征。使用 SPSS 12.0 软件进行数据分析。
平均年龄和标准差分别为 9.8（1.2）岁，50%为女孩，82.5%为 B 类和 C 类儿童。临床脂代谢障碍和血脂异常分别为 27.5%和 70%。躯干臂比和肢体躯干比与脂代谢障碍呈正相关。有脂代谢障碍的患者身材矮小，甘油三酯值较高，高密度脂蛋白胆固醇值较低。
通过皮褶和双能 X 射线吸收仪测量获得的比值可被视为临床前脂代谢障碍的指标。尚未确定临界点，但连续评估可能有助于识别早期身体成分变化。
