A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance is a common complication of HIV protease inhibitors. Diabetes mellitus is relatively uncommon.

Objective: To determine the effects of a 15-week high-intensity intermittent exercise (HIIE) program on subcutaneous and trunk fat and insulin resistance of young women. Design and procedures: Subjects were randomly assigned to one of the three groups: HIIE (n ¼ 15), steady-state exercise (SSE; n ¼ 15) or control (CONT; n ¼ 15). HIIE and SSE groups underwent a 15-week exercise intervention. Subjects: Forty-five women with a mean BMI of 23.2 ± 2.0 kg m À2 and age of 20.2 ± 2.0 years. Results: Both exercise groups demonstrated a significant improvement (Po0.05) in cardiovascular fitness. However, only the HIIE group had a significant reduction in total body mass (TBM), fat mass (FM), trunk fat and fasting plasma insulin levels. There was significant fat loss (Po0.05) in legs compared to arms in the HIIE group only. Lean compared to overweight women lost less fat after HIIE. Decreases in leptin concentrations were negatively correlated with increases in VO 2peak (r ¼ À0.57, Po0.05) and positively correlated with decreases in TBM (r ¼ 0.47; Po0.0001). There was no significant change in adiponectin levels after training. Conclusions: HIIE three times per week for 15 weeks compared to the same frequency of SSE exercise was associated with significant reductions in total body fat, subcutaneous leg and trunk fat, and insulin resistance in young women.

Objective-To investigate the utility of risk factors such as bone mineral density, lifestyle, and postural stability in the prediction of osteoporotic fractures.Design-Longitudinal, epidemiological, and population based survey.Setting-City ofDubbo, New South Wales. Subjects-All residents of Dubbo aged > 60 on 1 January 1989.Main outcome measure-Incidence of fracture for individual subjects.Results-The overall incidence of atraumatic fractures in men and women was 1.9% and 3.1% per annum respectively. The predominant sites of fracture were hip (18.9%), distal radius (18.5%), ribs and humerus (11/9% in each case), and ankle and foot (9.1% and 6.6% respectively). Major predictors of fractures in men and women were femoral neck bone mineral density, body sway, and quadriceps strength. Age, years since menopause, height, weight, and lifestyle factors were also correlated with bone mineral density and body sway and hence were indirect risk factors for fracture. Discriminant function analysis correctly identified 96% and 93% (sensitivities 88% and 81%) of men and women, respectively, who subsequently developed atraumatic fractures. Predictions based on this model indicated that a woman with a bone mineral density in the lowest quarfile in the hip together with high body sway had a 8.4% probability of fracture per annum. This represented an almost 14-fold increase in risk of fracture compared with a woman in the highest bone mineral density quartile with low postural sway. An individual with all three predictors in the "highest risk" quartile had a 13.1% risk of fracture per annum.Conclusions-Bone mineral density, body sway, and muscle strength are independent and powerfiu synergistic predictors offracture incidence. IntroductionThe observation of the relation between bone loss and fracture was probably first made by Antley Cooper in 1824, when he suggested that the increase in frequency of fracture was due to thinning of bone in elderly people.' Since then evidence has accumulated of an association between bone density and fracture. Population based studies show that hip fractures are uncommon among women with femoral neck bone mineral densities greater than the 70th centile of peak bone mass, but the frequency of fracture increases when bone mineral density falls below this level.23 Similarly, women in the lowest quintile of bone mineral content in the os calcis had a risk of non-spine fracture 10 times greater than women in the highest

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