The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings

 

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dc.contributor.author Abrahams, Zulfa
dc.contributor.author Dave, Joel A
dc.contributor.author Maartens, Gary
dc.contributor.author Lesosky, Maia
dc.contributor.author Levitt, Naomi S
dc.date.accessioned 2015-01-17T09:34:59Z
dc.date.available 2015-01-17T09:34:59Z
dc.date.issued 2014-08-04
dc.identifier.citation AIDS Research and Therapy. 2014 Aug 04;11(1):26 en_ZA
dc.identifier.uri http://dx.doi.org/10.1186/1742-6405-11-26
dc.identifier.uri http://hdl.handle.net/11427/12259
dc.description.abstract Abstract Background Lipohypertrophy does not appear to be an adverse ART reaction while lipoatrophy is clearly associated with the use of stavudine (d4T) and zidovudine (AZT). In low and middle income countries d4T has only recently been phased out and AZT is still widely being used. Several case definitions have been developed to diagnose lipodystrophy, but none of them are generalizable to sub-Saharan Africa where black women have less visceral adipose tissue and more subcutaneous adipose tissue than white women. We aimed to develop a simple, objective measure to define lipoatrophy and lipohypertrophy by comparing patient report to anthropometric and dual-energy X-ray absorptiometry (DXA) -derived variables. Methods DXA and anthropometric measures were obtained in a cross sectional sample of black HIV-infected South African men (n = 116) and women (n = 434) on ART. Self-reported information on fat gain or fat loss was collected using a standard questionnaire. Receiver operating characteristic (ROC) curves were used to describe the performance of anthropometric and DXA-derived variables using patient reported lipoatrophy and lipohypertrophy as the reference standard. Results Lipoatrophy and lipohypertrophy were more common in women (25% and 33% respectively) than in men (10% and 13% respectively). There were insufficient numbers of men with DXA scans for meaningful analysis. The best predictors of lipoatrophy in women were the anthropometric variables tricep (AUC = 0.725) and thigh skinfold (AUC =0.720) thicknesses; and the DXA-derived variables percentage lower limb fat (AUC = 0.705) and percentage lower limb fat/height (AUC = 0.713). The best predictors of lipohypertrophy in women were the anthropometric variable waist/hip ratio (AUC = 0.645) and the DXA-derived variable percentage trunk fat/percentage limb fat (AUC = 0.647). Conclusions We were able to develop simple, anthropometric measures for defining lipoatrophy and lipohypertrophy, using a sample of black HIV-infected South African women with DXA scans. This is of particular relevance in resource limited settings, where health professionals need simple and inexpensive methods of diagnosing patients with lipoatrophy and lipohypertrophy. en_ZA
dc.language eng en_ZA
dc.publisher BioMed Central en_ZA
dc.rights Creative Commons Attribution 4.0 International (CC BY 4.0) *
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en_ZA
dc.source AIDS Research and Therapy en_ZA
dc.source.uri http://www.aidsrestherapy.com/
dc.subject.other Lipoatrophy
dc.subject.other Lipohypertrophy
dc.subject.other Lipodystrophy
dc.subject.other Antiretroviral therapy
dc.title The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings en_ZA
dc.type Journal Article en_ZA
dc.date.updated 2015-01-15T17:52:25Z
dc.language.rfc3066 en
dc.rights.holder Abrahams et al.; licensee BioMed Central Ltd.
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Endocrinology and Diabetology en_ZA
uct.type.filetype
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Abrahams, Z., Dave, J. A., Maartens, G., Lesosky, M., & Levitt, N. S. (2014). The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings. <i>AIDS Research and Therapy</i>, http://hdl.handle.net/11427/12259 en_ZA
dc.identifier.chicagocitation Abrahams, Zulfa, Joel A Dave, Gary Maartens, Maia Lesosky, and Naomi S Levitt "The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings." <i>AIDS Research and Therapy</i> (2014) http://hdl.handle.net/11427/12259 en_ZA
dc.identifier.vancouvercitation Abrahams Z, Dave JA, Maartens G, Lesosky M, Levitt NS. The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings. AIDS Research and Therapy. 2014; http://hdl.handle.net/11427/12259. en_ZA
dc.identifier.ris TY - Journal Article AU - Abrahams, Zulfa AU - Dave, Joel A AU - Maartens, Gary AU - Lesosky, Maia AU - Levitt, Naomi S AB - Abstract Background Lipohypertrophy does not appear to be an adverse ART reaction while lipoatrophy is clearly associated with the use of stavudine (d4T) and zidovudine (AZT). In low and middle income countries d4T has only recently been phased out and AZT is still widely being used. Several case definitions have been developed to diagnose lipodystrophy, but none of them are generalizable to sub-Saharan Africa where black women have less visceral adipose tissue and more subcutaneous adipose tissue than white women. We aimed to develop a simple, objective measure to define lipoatrophy and lipohypertrophy by comparing patient report to anthropometric and dual-energy X-ray absorptiometry (DXA) -derived variables. Methods DXA and anthropometric measures were obtained in a cross sectional sample of black HIV-infected South African men (n = 116) and women (n = 434) on ART. Self-reported information on fat gain or fat loss was collected using a standard questionnaire. Receiver operating characteristic (ROC) curves were used to describe the performance of anthropometric and DXA-derived variables using patient reported lipoatrophy and lipohypertrophy as the reference standard. Results Lipoatrophy and lipohypertrophy were more common in women (25% and 33% respectively) than in men (10% and 13% respectively). There were insufficient numbers of men with DXA scans for meaningful analysis. The best predictors of lipoatrophy in women were the anthropometric variables tricep (AUC = 0.725) and thigh skinfold (AUC =0.720) thicknesses; and the DXA-derived variables percentage lower limb fat (AUC = 0.705) and percentage lower limb fat/height (AUC = 0.713). The best predictors of lipohypertrophy in women were the anthropometric variable waist/hip ratio (AUC = 0.645) and the DXA-derived variable percentage trunk fat/percentage limb fat (AUC = 0.647). Conclusions We were able to develop simple, anthropometric measures for defining lipoatrophy and lipohypertrophy, using a sample of black HIV-infected South African women with DXA scans. This is of particular relevance in resource limited settings, where health professionals need simple and inexpensive methods of diagnosing patients with lipoatrophy and lipohypertrophy. DA - 2014-08-04 DB - OpenUCT DO - 10.1186/1742-6405-11-26 DP - University of Cape Town J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings TI - The development of simple anthropometric measures to diagnose antiretroviral therapy-associated lipodystrophy in resource limited settings UR - http://hdl.handle.net/11427/12259 ER - en_ZA


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