Abstract
BackgroundAlthough half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. Thus, we evaluated the associations between waist circumference (WC) combined with triglyceride (TG) levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women.Methods1481 HIV-infected men and 841 HIV-infected women were recruited between 2005 and 2009 at the metabolic clinic of the University of Modena and Reggio Emilia in Italy. Within each gender, patients were categorized into 4 groups according to WC and TG levels. Total and regional fat and fat-free mass were assessed by duel-energy x-ray absorptiometry, and visceral adipose tissue (VAT) and abdominal subcutaneous AT (SAT) were quantified by computed tomography. Various cardiovascular risk factors were assessed in clinic after an overnight fast.ResultsThe high TG/high WC men had the most VAT (208.0±94.4 cm2), as well as the highest prevalence of metabolic syndrome (42.2%) and type-2 diabetes (16.2%), and the highest Framingham risk score (10.3±6.5) in comparison to other groups (p<0.05 for all). High TG/high WC women also had elevated VAT (150.0±97.9 cm2) and a higher prevalence of metabolic syndrome (53.3%), hypertension (30.5%) and type-2 diabetes (12.0%), and Framingham risk score(2.9±2.8) by comparison to low TG/low WC women (p<0.05 for all).ConclusionsA simple tool combining WC and TG levels can discriminate high- from low-risk HIV-infected patients.
Highlights
Lipodystrophy is commonly observed among HIV-infected patients receiving antiretroviral therapy (ART) [1]
The demographic, anthropometric, body composition and cardiovascular risk factors for the 1481 HIV-infected men and 841 women grouped according to their waist circumference (WC) and TG levels are presented in Tables 1 and 2, respectively
A similar pattern was observed among the women, with the high TG/high WC group being older (44.167.8 versus 42.365.7 years, respectively; p,0.05) and less active than the low TG/low WC group (22.2 versus 33.5% physically active, respectively; p,0.05)
Summary
Lipodystrophy is commonly observed among HIV-infected patients receiving antiretroviral therapy (ART) [1]. The majority of lipodystrophic HIVinfected patients exhibit the classic constellation of cardiovascular risk factors including visceral obesity, insulin resistance, dyslipidemia, hypertension, endothelial dysfunction [6], and subclinical atherosclerosis [7]. These patients are at significantly greater prospective risk of developing type-2 diabetes [8] or experiencing myocardial infarction [9]. Half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. We evaluated the associations between waist circumference (WC) combined with triglyceride (TG) levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women
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