Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models

Abstract

BackgroundBody composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.MethodsA cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.ResultsResults support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r2 = 0.78, SEE = 0.11, r2PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) (“Yes” for Asian race = 1; “No” = 0).ConclusionsThe proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA.

Frequency of osteopenia and osteoporosis in men and women living with HIV/Aids: an observational study

“…There is evidence suggesting that some classes of cART, especially PIs contribute to accelerating bone demineralization, which is associated with increased frequency of osteoporosis and risk of fractures in PLWHA 7,21,22 . However, we did not observe differences between sex in "time of exposure to cART" and use of PIs 15 .…”

“…Results about the average age of the participants, self-reported race/ethnicity, time of diagnosis of HIV, time of exposure to cART, type o cART, CD4+ T lymphocytes, and viral load account were previously described 15 . Briefly, we observed homogeneity of participants among age, time of diagnosis of HIV, time of exposure to cART treatment, CD4+ T lymphocytes, and viral load account (no one PLWHA showed detectable viral load) 15 . Detailed information on body composition measured by DXA separated by sex is provided in Table 1.…”

Association between changes in body fat distribution, biochemical profile, time of HIV diagnosis, and antiretroviral treatment in adults living with and without virus infection

“…The use of anthropometric indicators is advantageous, simple, of good reliability and applicable on a large scale. Authors have shown high values of positive and significant correlation between anthropometric and image methods to measure body fat distribution in patients with HIV and concluded that the anthropometric model has advanced in the field of public health, facilitating early diagnosis and better management of lipodystrophy in patients with HIV, with precision and a diagnosis prediction of 80% in this target group 23 .…”

Normalizing calf circumference to identify low skeletal muscle mass in older women: a cross-sectional study

“…SMM parameters can be obtained from dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis, magnetic resonance imaging, computed tomography, muscle biopsy, or magnetic resonance spectroscopy (2). However, these require skilled health professionals, and are high-cost and difficult to access in the context of regular clinical practice, particularly in low-and middle-income countries (7).…”