There are significant discrepancies concerning the incidence of HIV-associated lipodystrophy reported in previous studies. This has resulted from the lack of homogeneous criteria for the diagnosis of lipodystrophy.

Portuguese researchers proposed that the use of DEXA for determination of fat mass distribution could improve early detection and diagnosis of lipodystrophy. To evaluate this hypothesis, the researchers conducted a study that evaluated the fat mass ratio (FMR) by DEXA as a lipodystrophy index and correlated it with clinical lipodystrophy evaluation and with intra/extra abdominal fat ratio by CT scan. In addition, they evaluated the accuracy of this index in the diagnosis of lipodystrophy.

The research group studied 83 HIV patients (23 without lipodystrophy) by DEXA and CT scan. The FMR was defined by the ratio of the trunk fat mass percentage over the limbs fat mass percentage.

Results

• Clinical lipodystrophy (CL) patients had a significantly higher FMR than patients without lipodystrophy (WL).
• There was a significant correlation between FMR and intra/extra abdominal fat ratio (P<0.001).
• The clinical examination had a sensitivity of 90.2%, a specificity of 43.2%, a positive predictive value of 63.8% and a negative predictive value of 80%.

The researchers conclude, “The FMR seems to be an objective tool to more accurately diagnose the HIV lipodystrophy syndrome and simultaneously highly correlated with body composition evaluated by CT.”

12/09/05

Reference
P Freitas and others. Fat mass ratio: an objective tool of HIV lipodystrophy syndrome diagnosis? Abstract 36. 7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. November 13-16, 2005, Dublin, Ireland. Antiviral Therapy 2005; 10:L25.