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Session 90 Poster Session Incidence, Prevalence, and Pathogenic Correlates of Insulin Resistance and Lipodystrophy Syndrome Session Time: 4:30-6:30 pm Room 4E-F

685-T. Evolution of Fat Atrophy (FA) and Fat Deposition (FD) over 1 Year in a Cohort of HIV-Infected Men and Women D. L. Jacobson*, T. Knox, S. Gorbach, and C. Wanke Tufts Univ. Sch. of Med., Boston, MA Background: Few longitudinal studies have objectively evaluated the prevalence and the persistence or loss of FA and FD over time during HIV infection. Methods: Nutrition for Healthy Living (NFHL) is an ongoing prospective study of nutrition among HIV-positive men (n=294) and women (n=139). Between November 1999 and August 2001 we measured waist to hip ratio and tricep skin folds. We defined FA and FD by strict anthropometric criteria (FA: BMI > 20, triceps skin-folds < normal for sex and age); FD: BMI < 27, waist-hip ratio > 0.90 for women and > 0.95 for men). At first measurement, correlates of baseline prevalence of FA and FD were compared by Wilcoxon rank sum test or Fisher's exact test. Change in FA and FD were determined 1 year after first measurement. Results: Among those with BMI > 20, 46 of 259 men (18%) and 8 of 112 (7%) women had FA. Among the non-overweight, 84 of 219 (38%) men and 40 of 87 (46%) women had FD. Correlates: Both men and women with FA had lower REE (p<0.0001). FA-men had lower albumin (p=0.5) and FA-women had lower CD8 (p=0.02). Both FD-men and FD-women had higher triglycerides (p=.0.0002 and p=0.04) and were slightly older (p=0.02 and p=0.01). FD-men were more frequently Caucasian (p=0.0001), used HAART (p=0.02), had higher REE (p=0.01), and lower HIV viral load (p=0.03). FD-women had a larger past drop in CD4 cells (p=0.04). The persistence and change in FA and FD over 1 year was similar in men and women. Half of the FA-women and FA-men lost FA after 1 year. Among those without FA, 5% of men and 2% of women gained FA after 1 year. FD was maintained in 82% of men and 73% of women. More women than men without FD appeared to develop FD, 45% and 18%, respectively. A few men (14/143) and women (2/66) met the definition for both FA and FD at baseline. Few of the men and none of the women with mixed FA and FD at baseline had both after 1 year, 29% and 0% respectively. Conclusions: FA and FD appear to be separate syndromes. FD was more common than FA, and FA was more prevalent in women. A larger proportion of men and women lost FA than FD over one year. Acquisition of FD may be more common

©2002 9th Conference on Retroviruses and Opportunistic Infections