7th Conference - Abstract 24

Prevalence of Fat Deposition and Fat Atrophy in a Cohort of HIV-Infected Men and Women

C. WANKE*, D. JACOBSEN, T. KNOX, and S. GORBACH. Tufts Univ. Sch. of Med., Boston, MA

The true prevalence of lipodystrophy or fat redistribution syndrome in patients infected with HIV remains unclear as a working definition of the syndrome has been difficult to develop. We defined fat deposition (FD) and fat atrophy (FA) by strict anthropometric criteria (FD: BMI < 27, waist–hip ratio >0.90 for women and >0.95 for men; FA: BMI > 20, triceps skin-folds < normal for sex and age) and determined the prevalence and potential predictors of FD and FA in a cohort of HIV-infected adults. Sixty-three % (22/35) of the women met the definition of FD; 11% (4/38) of the women met the definition of FA. Thirty-six % (35/87) of the men met the definition of FD and 19% (23/120) met the definition of FA. No one in the cohort met the definition of both FD and FA. African-American men (25% of cohort) and women (46% of the cohort) were less likely to develop FD (p < 0.002 for men and 0.06 for women) than others. FD was associated with increased triglycerides in men (301 ng/dl) and women (275 ng/dl) (p<0.06 for men and 0.02 for women); FA was not. Neither FD nor FA was associated with the use of a highly active antiretroviral regimen (HAART), with or without protease inhibitors. Thirty % of the women and 60% of the men were taking or had taken HAART. Triceps, suprailiac and subscapular skin-folds were significantly decreased in men and women with FA when compared to those without FA. There was no association of FD or FA with drug use, use of anabolics, or appetite stimulants for either men or women.
Separate syndromes of FD and FA did occur in this cohort. FD was more common than FA and was more common in women than men. African-Americans appeared to be protected from FD. Simple anthropometric measures may be useful in the early identification of HIV-infected patients with FD or FA.

Key Words: fat atrophy, fat deposition, lipodystrophy