Validação de métodos de estimativa da gordura corporal em portadores do HIV/Aids

Abstract

ObjectiveTo validate different methods for estimating HIV/Aids patients' body fat: total body skinfold thickness, central (trunk) skinfold thickness, peripheral (limb) skinfold thickness, waist circumference (WC) and waist-to-hip ratio (WHR). Dual-energy Xray absorptiometry (DEXA) and computed tomography of the abdomen (CTA) were used as the gold standard. Methods An analysis was done on 15 adult HIV/AIDS patients (10 men and 5 women) who were being treated at the AIDS Clinic at a public university hospital, São Paulo, Brazil. Their total subcutaneous fat (TSF) was estimated from the sum of the thicknesses of the biceps, triceps, subscapular, midaxillary, suprailiac, abdominal and medial calf skinfolds. The central subcutaneous fat (CSF) was estimated by summing the subscapular, axillary, suprailiac and abdominal skinfold measurements. The peripheral subcutaneous fat (PSF) was estimated by summing the biceps, triceps and medial calf skinfold measurements. These were compared with DEXA. The WC, WHR and CSF were compared with CTA. In the statistical analysis, the Pearson correlation coefficient (r) and Mann-Whitney test were utilized. Results There was a correlation between fat mass measured by DEXA and by TSF, CSF and PSF, even after adjusting for age (r≥0.80 for all). WC, WHR and CSF presented correlation with total abdominal fat measured by CTA, even after adjusting for age (r≥0.80 for all). ConclusionsThe methods for estimating body fat should be chosen according to the type of fat to be evaluated and can be used in research and healthcare services instead of DEXA and CTA for HIV/AIDS patients.

Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil

“…The complexity of HIV infection and its consequences reinforce the need of health-related actions to maintain the nutritional status of this group of patients. As the subjects of most Brazilian studies on this matter are patients of one single clinic, 13,14,17,18,19,20,21 and few include a higher number of clinics connected to a health care network 15,16,22,23 , the investigations on the nutritional status of HIV/ AIDS individuals, particularly those focusing on undernourishment, in a sample of patients attended in a public healthcare network with facilities broadly distributed over a geographic area, such as the one of the city of São Paulo, Brazil, may contribute for the understanding of this phenomenon.…”

The Effect of Antiretroviral Therapy (ART) on Body Composition and Clinical Markers of Lipodystrophy in HIV-Infected Children Assessed in Follow-Up Study

“…Therefore, anthropometry and other non-invasive bedside methods should be evaluated. There is evidence of correlation between fat mass measured by anthropometric skinfolds thickness and DEXA in HIV-infected patients with lipodystrophy [15]. Therefore anthropometry methods can be used in healthcare services as one of validated methods for estimating body fat in HIV-infected patients.…”

Can anthropometry measure the body fat of people living with HIV/AIDS?: A systematic review

“…When evaluating fat types by CT, Florindo y Cols. 30 noted a strong correlation between WC and abdominal fat (r=0.89) as well as subcutaneous fat (r=0.88). However, on evaluating the relation between WC and visceral fat, moderate correlation was noted (r=0.61).…”

“…Six studies were exclusively focused on men 27,28,32,33,35 and five studies were on both sexes 22,[25][26][27][29][30][31]34 .…”

“…Mean duration of antiretroviral therapy was observed in eight studies [25][26][27]29,30,32,34,35 . Among the 11 selected studies, only In comparison with anthropometric indexes or indicators, predictive equations for fat showed stronger correlations with total body fat percentage, especially the expressions from Thorland (r=0.849), Katch (r=0.848), Sloan (r=0.847), Steinkamp (r=0.82), Durnin (r=0.828; r=0.69) 28,33 .…”