Grenha Inês, Oliveira Joana, Lau Eva, Santos Ana Cristina, Sarmento António, Pereira Jorge, Carvalho Davide, Freitas Paula
Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar São João, Faculty of Medicine, i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar São João, Faculty of Medicine, i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
J Clin Densitom. 2018 Jan-Mar;21(1):75-82. doi: 10.1016/j.jocd.2016.07.010. Epub 2016 Dec 27.
In HIV-infected patients, combined antiretroviral therapy (cART) is associated to adipose tissue redistribution known as lipodystrophy and associated cardiometabolic risk. This study aimed to evaluate the evolution of body composition in HIV-infected patients, with and without lipodystrophy, over 2 yr. We evaluated anthropometric parameters and body composition by whole-body dual-energy X-ray absorptiometry in 144 HIV-infected patients on cART. We defined lipodystrophy by fat mass ratio. Lipodystrophy was present in 45.77% of the patients. These patients presented higher HIV infection duration, cART duration, and CD4+ cell count, with no differences regarding gender, age, body mass index, and viral load. Patients with lipodystrophy showed an increase in total fat mass (9.9%) and upper-limbs fat mass (17.6%), with a decrease in total, trunk, and lower-limbs fat-free mass (2.2%; 2.2%, and 3.9%, respectively), over 2 yr. In patients without lipodystrophy, the trunk fat-free mass decreased 1.9% over time, and no changes were observed in the other studied parameters. In patients with lipodystrophy, there was predominantly a central fat mass gain, with no changes in lower limbs, suggesting that peripheral adipocytes lose their regenerative capacity.
在HIV感染患者中，联合抗逆转录病毒疗法（cART）与被称为脂肪代谢障碍的脂肪组织重新分布及相关的心脏代谢风险有关。本研究旨在评估有或无脂肪代谢障碍的HIV感染患者在两年内身体成分的变化。我们通过全身双能X线吸收法对144例接受cART治疗的HIV感染患者的人体测量参数和身体成分进行了评估。我们根据脂肪质量比定义脂肪代谢障碍。45.77%的患者存在脂肪代谢障碍。这些患者的HIV感染持续时间、cART治疗持续时间和CD4+细胞计数较高，在性别、年龄、体重指数和病毒载量方面无差异。有脂肪代谢障碍的患者在两年内总脂肪量增加了9.9%，上肢脂肪量增加了17.6%，而总去脂体重、躯干去脂体重和下肢去脂体重分别减少了2.2%、2.2%和3.9%。在无脂肪代谢障碍的患者中，躯干去脂体重随时间下降了1.9%，其他研究参数未观察到变化。在有脂肪代谢障碍的患者中，主要是中央脂肪量增加，下肢无变化，这表明外周脂肪细胞失去了再生能力。
