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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 8, Issue.: 7


Body Composition Changes and Predictors of Lipodystrophy in a Cohort of Pre-pubertal HIV- infected Children


Cecília Zanin Palchetti1, Regina Célia de Menezes Succi2, Vera Lúcia Szejnfeld3, Patrícia Fonseca Teixeira1, Rose Vega Patin1, Aída de Fátima Thomé Barbosa2 and Fernanda Luisa Ceragioli Oliveira1*
1Division of Nutrology, Departament of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP/EPM), 04040-032, São Paulo, SP, Brazil.
2Division of Pediatric Infectious Diseases, Departament of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP/EPM), 04040-003 São Paulo, SP, Brazil.
3Division of Rheumatology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP/EPM), 04023-900, São Paulo, Brazil.

Article Information
(1) Roberto Manfredi, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
(1) Klaudija Viskovic, Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Croatia.
(2) Aurea Regina Telles Pupulin, Department of Basic Sciences of Health-State University of Maringa, Brazil.
(3) Anonymous, University of Namibia, Namibia.
Complete Peer review History: http://www.sciencedomain.org/review-history/9286


Aim: To evaluate body composition changes in HIV-infected patients and to identify the predictors of lipodystrophy over time.
Methods: A cohort study, evaluated over two and a half years (Time 1: T1; Time 2: T2), including prepubertal HIV-infected children of both genders, between 7-12 years of age. Patient’s data such as transmission, use of prophylaxis for vertical HIV transmission, clinical and immunological classification of disease and current antiretroviral therapy were derived from the medical records. At T1, only subjects with pubertal stage 1 were included. Clinical, anthropometric, body composition and biochemical data were assessed. Patients were divided into two groups: with (LD+) and without lipodystrophy (LD-).
Results: A total of 40 patients were enrolled, and 35 patients completed the study. Mean (SD) age was 9.6 (1.1) and 11.6 (1.2) years at T1 and T2, respectively. At T2, 16 (45.7%) children remained prepubertal. LD+ group (n = 8) showed a higher prevalence of short stature (p = 0.008) in T1; higher insulin (p = 0.010) and HOMA-IR (p = 0.013) and reduction of triceps skinfold thickness (p = 0.026) at T2. In both times, we observed lower concentrations of HDLc (p = 0.027), higher values of trunk to arm ratio (p = 0.002, p = 0.001) and lower values of limb to trunk ratio (p = 0.001) and gynoid fat (p= 0.001) in LD+ group. At T1, predictors of lipodystrophy were short stature (OR = 46.198, p = 0.019) and limb to trunk ratio (OR = 0.00009, p = 0.011); in T2, waist circumference (OR = 1.199, p = 0.025) and HDLc (OR = 0.835, p = 0.015). Presence of lipodystrophy was determinant of high insulin levels at T2.
Conclusion: In a short period, LD+ group had significant changes in body fat distribution and also biochemical alterations associated to lipodystrophy syndrome.

Keywords :

HIV; child; body composition; lipodystrophy.

Full Article - PDF    Page 601-611

DOI : 10.9734/BJMMR/2015/17782

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