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Body Composition and Metabolic Syndrome Components on Lipodystrophy Different Subtypes Associated with HIV
Livia Bertazzo Sacilotto1, Paulo Câmara Marques Pereira1, João Paulo Vieira Manechini2
1Botucatu Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil.
Insights
HIV-associated lipodystrophy syndrome (HALS) involves body fat changes from antiretroviral therapy (ART). Despite anthropometric differences, HALS subtypes did not show distinct metabolic profiles in PLHA.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Cardiovascular Health
Background:
- HIV-associated lipodystrophy syndrome (HALS) results from antiretroviral therapy (ART), causing body fat redistribution.
- HALS increases cardiovascular disease risk and is subjectively diagnosed into lipoatrophy, lipohyperpertrophy, or mixed subtypes.
- Metabolic alterations may accompany HALS, impacting patient health outcomes.
Purpose of the Study:
- To investigate metabolic profiles across different HALS subtypes in people living with HIV/AIDS (PLHA).
- To compare anthropometric and metabolic differences between genders within the HALS population.
- To assess the relationship between body composition and metabolic markers in HALS patients.
Main Methods:
- Assessment of 40 PLHA diagnosed with HALS, undergoing regular ART and ambulatory follow-up.
- Evaluation of anthropometric measurements including body fat percentage, visceral fat area (VFA), BMI, and circumferences.
- Analysis of lipid profiles and metabolic markers across HALS subtypes and genders.
Main Results:
- Women exhibited greater lipid profile alterations compared to men.
- No significant metabolic profile differences were observed between HALS subtypes.
- The lipohypertrophy group showed increased total body fat, VFA, BMI, and circumferences; BMI correlated strongly with VFA.
Conclusions:
- Anthropometric alterations in HALS are not consistently accompanied by metabolic disturbances across subtypes.
- Lipohypertrophy is associated with significant increases in body fat and BMI.
- Preventive strategies focusing on behavioral changes are crucial for mitigating cardiovascular risk in PLHA with HALS.
Abstract:
HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated with an increased risk of cardiovascular disease development. Subjective diagnosis, classified between three subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy, and mixed lipodystrophy, is possibly accompanied with metabolic alterations. Forty people living with HIV/AIDS (PLHA), with clinical diagnosis of HALS and from both genders, were assessed. They performed ambulatorial follow-up and used ART regularly. The main findings were greater lipid profile alterations among women, while no metabolic profile differences were found between the HALS subtypes. The lipohypertrophy group showed major alterations, with higher values for total body fat percent, visceral fat area (VFA), body mass index (BMI), and abdominal and neck circumferences when compared to the other groups. Lean body mass was superior only compared to the mixed lipodystrophy group, and fat mass only compared to the lipoatrophy group. BMI showed strong correlation with the VFA. In conclusion, despite anthropometric alterations related to HALS these individuals present, those are not accompanied with metabolic alterations. Strategies, as behavioral changes and disorders prevention, are important to decrease the risk of cardiovascular disease development.
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