Composição corporal e componentes da síndrome metabólica nos diferentes subtipos de lipodistrofia associada ao HIV
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Data
2017-02-21
Autores
Sacilotto, Lívia Bertazzo [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A lipodistrofia associada ao HIV (LAHIV) é caracterizada pela redistribuição de gordura corporal, sendo uma das consequências da introdução da terapia antirretroviral (TARV) e relacionada ao aumento do risco para o desenvolvimento de doenças cardiovasculares. Seu diagnóstico é subjetivo e classificado em três tipos, de acordo com a região corporal em que há perda e/ou acúmulo de gordura, a saber, lipoatrofia, lipohipertrofia e lipodistrofia mista, acompanhada ou não de alterações metabólicas. O objetivo do presente trabalho foi verificar a associação dos diferentes subtipos de LAHIV em pessoas vivendo com HIV/aids com os componentes da síndrome metabólica e composição corporal. Foram avaliados dados clínicos, imunológicos, metabólicos, antropométricos e composição corporal de 40 pessoas vivendo com HIV/aids em acompanhamento ambulatorial e uso regular de TARV, de ambos os sexos, com diagnóstico clínico de LAHIV. Os principais achados do estudo foram maiores alterações de perfil lipídico entre as mulheres. Não houve diferença estatística entre os subtipos para o perfil metabólico. As principais alterações foram identificadas no grupo lipohipertrofia, que tiveram maiores valores de porcentual de gordura corporal total, área de gordura visceral (AGV), índice de massa corpórea (IMC) e circunferências abdominal e do pescoço em relação aos outros dois grupos. A massa magra foi superior apenas em relação ao grupo lipodistrofia mista e a massa de gordura em relação ao grupo lipoatrofia. O IMC mostrou forte correlação com a AGV. Em conclusão, o presente estudo mostrou que apesar destes indivíduos apresentarem alterações de indicadores antropométricos importantes relacionadas ao diagnóstico de LAHIV, não são acompanhadas de alterações metabólicas. Estratégias como mudança comportamental, identificação, prevenção e tratamento de doenças crônicas são importantes para reduzir os riscos para o desenvolvimento de doenças cardiovasculares.
HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated to an increased risk of cardiovascular disease development. Subjective diagnoses, classified between tree subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy and mixed lipodystrophy, are possibly accompanied of metabolic alterations. The objetive of the present study was to verify the association between HALS different subtypes, in people living with HIV/aids, and the components of metabolic syndrome and body composition. Forty PLHA, with clinical diagnosis of HALS and from both genders, were assessed. They performed ambulatorial follow up and used ART regularly. The main findings were greater lipid profile alterations among women, while no metabolic profile differences were found between the HALS subtypes. The lipohypertrophy group showed major alterations, with higher values for total body fat percent, visceral fat area (VFA), body mass index (BMI), abdominal and neck circumferences when compared to the other groups. Lean body mass was superior only compared to the mixed lipodystrophy group, and fat mass only compared to the lipoatrophy group. BMI showed strong correlation to the VFA. In conclusion, despite anthropometric alterations related to HALS these individuals present, those are not accompanied by metabolic alterations. Strategies, as behavioral changes and disorders prevention are important to decrease the risk of cardiovascular disease development.
HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated to an increased risk of cardiovascular disease development. Subjective diagnoses, classified between tree subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy and mixed lipodystrophy, are possibly accompanied of metabolic alterations. The objetive of the present study was to verify the association between HALS different subtypes, in people living with HIV/aids, and the components of metabolic syndrome and body composition. Forty PLHA, with clinical diagnosis of HALS and from both genders, were assessed. They performed ambulatorial follow up and used ART regularly. The main findings were greater lipid profile alterations among women, while no metabolic profile differences were found between the HALS subtypes. The lipohypertrophy group showed major alterations, with higher values for total body fat percent, visceral fat area (VFA), body mass index (BMI), abdominal and neck circumferences when compared to the other groups. Lean body mass was superior only compared to the mixed lipodystrophy group, and fat mass only compared to the lipoatrophy group. BMI showed strong correlation to the VFA. In conclusion, despite anthropometric alterations related to HALS these individuals present, those are not accompanied by metabolic alterations. Strategies, as behavioral changes and disorders prevention are important to decrease the risk of cardiovascular disease development.
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Palavras-chave
Pessoas vivendo com HIV/aids, Lipodistrofia, Composição corporal, Síndrome metabólica, People living with HIV/aids, Lipodystrophy, Body composition, Metabolic syndrome