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Session 100 Poster Abstracts
Dyslipidemias and Body Fat Abnormalities: Incidence, Risk Factors, Response to Therapy
Monday, 1:30 - 3:30 pm
Poster Hall


727    
Evaluation of Ultrasound for Assessing Facial Lipoatrophy in a Randomized, Placebo-controlled Trial
D Carey*1, H Wand1, A Martin1, S Emery1, A Carr2, D Cooper1,2, and the ROSEY Study Group
1Univ. of New South Wales, Sydney, Australia and 2St. Vincent's Hosp., Sydney, Australia

Background:  Facial lipoatrophy commonly complicates combination antiretroviral therapy and may stigmatise patients. This 48-week, randomized, double-blind, placebo-controlled trial investigated the effect of rosiglitazone (RSG) therapy on peripheral lipoatrophy in HIV+ subjects receiving combination antiretroviral therapy. Subjects were able to co-enrol in a malar sub-study, which aimed to investigate the utility of ultrasonography for quantifying facial lipoatrophy.

Methods:  Subjects had a single ultrasonographic assessment of the maximal subcutaneous fat depth over the right malar bone performed at 3 points (weeks 0, 24, 48) on one scanner. Intent-to-treat analysis was employed. Changes from baseline to week 48 in primary and secondary endpoints were summarized by randomized treatment group using descriptive statistics. Differences between treatment groups were formally tested using non-parametric methods. Bivariate associations between facial fat changes and other body composition parameters were summarized using Spearman's correlation coefficients.

Results:  Of the 108 subjects recruited to the main RSG trial, 56 (52%) enrolled in the ultrasound study of which 51 (91%) completed all 3 scans. At week 48 maximal subcutaneous fat depth had decreased in both arms; by 0.16 mm in the RSG arm (n = 23) and by 0.20 mm in the placebo arm (n = 28) (mean difference, 0.04 [95% CI:  0.09, 0.16] mm; p = 0.43). No significant associations were shown between change from baseline to week 48 in maximal subcutaneous fat depth and the following body composition parameters:  limb fat, by DEXA, (r = 0.10; p = ns), mid-thigh subcutaneous fat, by CT, (r = 0.10; p = ns), Lipodystrophy Case Definition score (r = 0.11; p = ns) or change in patient self-assessed facial lipoatrophy (r = 0.11;  p = ns).

Conclusions:  Ultrasonography did not correlate significantly with more established measures of lipoatrophy severity. Nevertheless, RSG 4 mg twice daily did not appear to improve facial lipoatrophy using this technique. Based on these data, measurement of malar fat using ultrasonography is not recommended.

Keywords: facial lipoatrophy; assessment; ultrasonography