Highly active antiretroviral-treated HIV-infected children show fat distribution changes even in absence of lipodystrophy

Brambilla, Paolo; Bricalli, Dorella; Sala, Nathalie; Renzetti, Federica; Manzoni, P; Vanzulli, Angelo; Chiumello, G; Natale, B. Di; Viganò, Alessandra

doi:10.1097/00002030-200112070-00009

Cited by 79 publications

(53 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regional analysis of body fat composition by various techniques like DEXA (31,35) , bioelectric impedence (25) and measurement of skin fold thickness (32) are more sensitive methods. Due to limitation of resources, subjective method was used to assess fat redistribution.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism responsible for this syndrome remains unclear. It has been proposed that antiretroviral drugs such as protease inhibitors (PI) and/ or nucleoside analogues (stavudine) could contribute to the development of such clinical and metabolic abnormalities (2,6,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(28)(29)(30)(31)(32)(33)(34)(35) . Various risk factors have been found to be associated with the development of lipodystrophy like older age and increasing duration of treatment (22,33,34,35) .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Bhutia¹,

Hemal²,

Yadav³

et al. 2014

Afr H. Sci.

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Bhutia¹,

Hemal²,

Yadav³

et al. 2014

Afr H. Sci.

View full text Add to dashboard Cite

“…As anthropometry alone does not allow precise characterization of these changes, alternate diagnostic tools have been used to improve the evaluation of the distribution of body fat [26]. DEXA (dual energy X-ray absortiometry) is considered the gold standard for the study of fat composition and distribution in children, while computed tomography and magnetic resonance imaging are indicated for detecting abdominal fat [26].…”

Section: Body Fat Redistributionmentioning

confidence: 99%

“…DEXA (dual energy X-ray absortiometry) is considered the gold standard for the study of fat composition and distribution in children, while computed tomography and magnetic resonance imaging are indicated for detecting abdominal fat [26]. However, high cost, the need for sedation and absence of reference values limit the use of these methods [5,25,27].…”

Section: Body Fat Redistributionmentioning

confidence: 99%

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

2008

View full text Add to dashboard Cite

The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohipertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohipertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS is also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Treatment includes physical activity, cautious restriction of caloric intake, changes in antiretroviral therapy, and use of insulin-sensitizing and lipid-lowering agents. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

show abstract

“…Therefore, only a few studies have used DXA to objectively identify altered fat distribution in children with HIV. 7,8 Furthermore, studies on the possible association of lipodystrophic phenotype with metabolic changes have yielded conflicting results. [9][10][11] Our aim was therefore to evaluate body composition by DXA in a cohort of Greek HIV-1 infected children and adolescents on ART.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of lipodystrophic and metabolic abnormalities in HIV-1 infected children on antiretroviral therapy

Spoulou¹,

Kanaka‐Gantenbein²,

Bathrellou

et al. 2011

View full text Add to dashboard Cite

ObjecTIVe: Few studies have thus far assessed body composition by dual energy X-ray absorptrometry (DXA) in children with HIV, primarily because reference data for normally growing children and adolescents are not available. Our study aimed at evaluating body composition in children with HIV and their relatiοn to serum lipids and glucose homeostasis. DeSIgn: body composition was assessed by DXA in 17 HIV-1 infected children at entrance to the study and after 12 months and in one hundred fifty nine age, gender, body mass index (bMI), and Tanner stage matched healthy subjects who served as controls. lipodystrophy was diagnosed if the trunk/leg fat ratio was out of the range of the expected mean±1SD of the controls. ReSUlTS: At study entry, 10 patients (7 girls) had developed lipohypertrophy, whereas all remaining patients had lipoatrophy. lipohypertrophy was associated with older age (p=0.027). lipodystrophic phenotype was stable in all patients except in one over the 12-month period of follow-up while on continuous antiretroviral therapy (ART). 80% and 70% of patients with lipohypertrophy had triglycerides and cholesterol levels, respectively above the 75 th percentile, while 57% and 43% of patients with lipoatrophy had triglycerides and cholesterol, respectively greater than the 75 th percentile. High triglycerides were associated with the use of protease inhibitors (p=0.028). basal fasting glucose and homeostasis model assessment (HOMA) values were within normal limits. cOnclUSIOnS: HIV-infected paediatric patients on continuous ART developed significant and persistent body composition changes which were associated with dyslipidemia without overt abnormalities of glucose metabolism.

show abstract

Highly active antiretroviral-treated HIV-infected children show fat distribution changes even in absence of lipodystrophy

Abstract: Increased central fat and peripheral lipoatrophy are distinctive features of all HAART-treated children. Changes in body fat composition are detectable by DXA even in the absence of signs of Lipodystrophy. Only LD+ show true central obesity.

Cited by 79 publications

References 30 publications

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

Monitoring of lipodystrophic and metabolic abnormalities in HIV-1 infected children on antiretroviral therapy

Contact Info

Product

Resources

About