Fat distribution and metabolic changes in patients with HIV infection.
Fat distribution and metabolic changes in patients with HIV infection.
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HIV感染者的脂肪分布和代谢变化。
DOI：
10.1097/00002030-199912240-00002
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Grunfeld,C
中科院分区：
文献类型：
--
作者：
Safrin,S;Grunfeld,C
最近关于HIV感染患者局部脂肪沉积和脂肪损失增加以及代谢物和激素血清水平变化的报道，导致了脂肪代谢障碍综合征正在发生的建议。虽然脂肪代谢障碍综合征通常归因于使用HIV蛋白酶抑制剂（PI）药物，但该综合征没有标准定义，归因通常通过自我报告，患病率估计差异很大。此外，脂肪代谢障碍与使用PI的关联，以及身体成分变化与代谢异常的相互关系，也受到了挑战。在这篇综述中，我们描述了来自英语医学文献的流行率估计，这些文献涉及脂肪区域增加（脂肪肥大：1-56%），脂肪区域损失（脂肪萎缩; 1-24%）和合并的“脂肪营养不良”综合征（2-83%）。广泛的患病率估计可能是由于不同的定义，方法（如自我报告与客观测量）和患者人群。身体组成变化与PI使用的关系越来越不清楚，分析显示了多种其他潜在的影响因素，如其他类型的抗逆转录病毒药物、抗逆转录病毒治疗的持续时间、病毒载量变化、体重、年龄和性别。关于个体之间脂肪再分布变化之间的关联性的数据很少。此外，脂肪分布与代谢变化（如高脂血症和胰岛素抵抗）之间的关联也越来越受到质疑; PI可能在代谢变化中发挥独立作用。未来的研究必须使用客观测量而不是主观报告来离散地检查脂肪分布中的每一个局部异常。辅助因子的识别至关重要，必须包括完整的用药史、病毒载量、体重、年龄和性别等。由于报告的一些变化发生在非艾滋病毒感染者中，因此必须计算超出对照人群的过度流行率。在定义一个综合征或多个综合征之前，必须首先分析个体变化彼此之间的关联以及与促成因素的关联。
Recent reports of localized areas of increased fat deposition and fat loss in HIV-infected patients, as well as changes in serum levels of metabolites and hormones, have led to the proposal that a lipodystrophy syndrome is occurring. Although the lipodystrophy syndrome is often attributed to the use of HIV protease inhibitor (PI) agents, there is no standard definition of the syndrome, attribution is often by self-report, and prevalence estimates vary widely. In addition, the association of lipodystrophy with use of PI, as well as the interrelationship of body composition changes with metabolic abnormalities, have been challenged. In this review we describe prevalence estimates derived from a review of the English language medical literature with regard to regional increases in fat (lipohypertrophy: 1-56%), regional loss of fat (lipoatrophy; 1-24%), and pooled ‚lipodystrophy ‚syndromes (2-83%). The wide range of prevalence estimates may be due to differing definitions, methods (eg self-report versus objective measurements) and patient populations. The relationship of changes in body composition to use of PI is increasingly less clear, and analysis reveals multiple other potential contributing factors such as other classes of antiretroviral agents, duration of antiretroviral therapy, change in viral load, body weight, age, and gender. There are few data on the association of individual changes in fat redistribution with each other. Moreover, the association between fat distribution and metabolic changes such as hyperlipidemia and insulin resistance is also increasingly questioned; PI may play an independent role in metabolic changes. Future studies must examine each localized abnormality in fat distribution discretely, using objective measurements rather than subjective report. Discernment of contributing cofactors is critical and must include, among others, complete medication history, viral load, body weight, age and gender. Because some of the reported changes occur in non-HIV-infected individuals, it is important to calculate the excess prevalence above control populations. The association of individual changes with each other and with contributing factors must be analyzed first, before the definition of a syndrome or of multiple syndromes can be made.
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影响因子：
6
作者：
M. Hommes;J. Romijn;E. Endert;J. K. E. Eeftinck Schattenkerk;H. Sauerwein
通讯作者：
H. Sauerwein
影响因子：
7.1
作者：
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DOI：
--
发表时间：
1992
期刊：
The Lancet
影响因子：
--
作者：
D. Mildvan;I. Wilets;S. G. Machado;S. Grossberg
通讯作者：
S. Grossberg
影响因子：
105.7
作者：
LARSSON, B;SVARDSUDD, K;TIBBLIN, G
通讯作者：
TIBBLIN, G
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DOI：
10.1210/jcem.77.4.8408471
发表时间：
1993
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Mulligan,K;Grunfeld,C;Hellerstein,MK;Neese,RA;Schambelan,M
通讯作者：
Schambelan,M