Alencastro Paulo R, Barcellos Nemora T, Wolff Fernando H, Ikeda Maria Letícia R, Schuelter-Trevisol Fabiana, Brandão Ajácio B M, Fuchs Sandra C
Hospital Sanatório Partenon, State Department of Health, Rio Grande do Sul. Av. Bento Gonçalves, 3722, Porto Alegre, RS, 90650-001, Brazil.
Post-graduate Program of Collective Health, Universidade do Vale do Rio dos Sinos, Av. Unisinos, 950, São Leopoldo, RS, 93022-750, Brazil.
BMC Res Notes. 2017 Jan 13;10(1):40. doi: 10.1186/s13104-017-2377-3.
The prevalence of lipodystrophy ranges from 31 to 65%, depending on the criteria adopted for diagnosis. The usual methods applied in the diagnosis vary from self-perception, medical examination, skinfolds measurements, or even imaging assessment for confirmation of fat distribution changes. Although several methods have been developed, there is no gold standard for characterization of LA and LH, or mixed forms. This study aimed to compare self-reported signs of lipodystrophy with objective measures by skinfolds and circumferences, and to evaluate the prevalence of lipoatrophy (LA) and lipohypertrophy (LH) among subjects living with HIV/AIDS on ART.
A cross-sectional study enrolled participants living with HIV/AIDS receiving ART, aged 18 years or older from an outpatient health care center, in Southern Brazil. Self-reported body fat enlargement in the abdomen, chest or breasts, and dorsocervical fat pad were used to determine LH, while LA was identified by self-reported fat wasting of the face, neck, legs, arms or buttocks. Measurements were obtained with a scientific caliper for infraorbital, buccal, and submandibular skinfolds, and using an inelastic tape to measure circumferences of waist, hip, neck, and arm. LH and LA were established by the presence of at least one self-reported sign.
Comparisons of self-reported signs with objective measurements for men and women were carried out in 815 participants on ART, out of 1240 participants with HIV infection. Self-report of decreased facial fat and sunken cheeks was associated with lower infraorbital, buccal, and submandibular skinfolds. Participants who reported buffalo hump had, on average, greater neck circumference, as well as those who have increased waist circumference also reported abdominal enlargement, but no buttock wasting. Men were most commonly affected by lipoatrophy (73 vs. 53%; P < 0.001), and women by lipohypertrophy (79 vs. 56%; P < 0.001).
In conclusion, self-reported signs of lipodystrophy and lipoatrophy are prevalent, differ by gender, and are associated with objective measurements in people living with HIV/AIDS.
脂肪代谢障碍的患病率在31%至65%之间，具体取决于所采用的诊断标准。诊断中常用的方法各不相同，包括自我感知、医学检查、皮褶测量，甚至通过影像学评估来确认脂肪分布变化。尽管已经开发了多种方法，但对于局限性脂肪萎缩（LA）和脂肪增生（LH）或混合形式的特征描述，尚无金标准。本研究旨在比较自我报告的脂肪代谢障碍体征与通过皮褶和周长进行的客观测量，并评估接受抗逆转录病毒治疗（ART）的艾滋病毒/艾滋病患者中脂肪萎缩（LA）和脂肪增生（LH）的患病率。
一项横断面研究纳入了来自巴西南部一家门诊医疗中心的18岁及以上接受ART治疗的艾滋病毒/艾滋病患者。通过自我报告腹部、胸部或乳房的体脂增大以及颈后脂肪垫来确定LH，而通过自我报告面部、颈部、腿部、手臂或臀部的脂肪消耗来确定LA。使用科学卡尺测量眶下、颊部和下颌下皮褶，并使用无弹性卷尺测量腰围、臀围、颈围和臂围。通过至少一种自我报告的体征来确定LH和LA。
在1240名艾滋病毒感染者中，对815名接受ART治疗的参与者进行了自我报告体征与男女客观测量结果的比较。自我报告面部脂肪减少和脸颊凹陷与较低的眶下、颊部和下颌下皮褶相关。报告有水牛背的参与者平均颈围更大，腰围增加的参与者也报告有腹部增大，但没有臀部消瘦。男性最常受脂肪萎缩影响（73%对53%；P<0.001），女性则最常受脂肪增生影响（79%对56%；P<0.001）。
总之，自我报告的脂肪代谢障碍和脂肪萎缩体征普遍存在，存在性别差异，并且与艾滋病毒/艾滋病患者的客观测量结果相关。
