Mixed patterns of changes in central and peripheral fat following initiation of antiretroviral therapy in a randomized trial.

TitleMixed patterns of changes in central and peripheral fat following initiation of antiretroviral therapy in a randomized trial.
Publication TypeJournal Article
Year of Publication2006
AuthorsMulligan K, Parker RA, Komarow L, Grinspoon SK, Tebas P, Robbins GK, Roubenoff R, Dubé MP
JournalJ Acquir Immune Defic Syndr
Volume41
Issue5
Pagination590-7
Date Published2006 Apr 15
ISSN1525-4135
KeywordsAbsorptiometry, Photon, Adipose Tissue, Adult, Anti-HIV Agents, Body Size, Body Weight, Female, HIV Infections, Humans, Male, Regression Analysis
Abstract

INTRODUCTION: Although peripheral fat loss is a consistent feature of HIV-associated lipodystrophy, less is known about whether changes in central and peripheral fat occur in tandem or independently over time. We examined intraindividual changes in dual-energy x-ray absorptiometry (DEXA) and anthropometry data over 64 weeks after initiation of antiretroviral therapy (ART).

METHODS: In ACTG 384, ART-naive subjects were randomized to receive didanosine and stavudine or zidovudine and lamivudine plus efavirenz, nelfinavir, or both. In the metabolic substudy A5005S (N= 329), waist, hip, thigh, and arm circumferences were measured in triplicate. DEXA scanning was performed in 157 subjects.

RESULTS: Individual changes in limb and trunk fat at week 64 correlated positively (R =.72, P <.001). Most subjects had directionally concordant changes in limb and trunk fat (36% gained and 32% lost in both regions). In 26%, trunk fat increased while limb fat decreased, whereas the reverse occurred in only 6% (P <.001). Changes in waist and hip circumferences also correlated positively (R =.62, P <.001). The proportion of subjects with waist/hip ratio more than .95 (men) or .90 (women) was 34% at baseline and 47% at week 64 (P =.003). In those who developed increased waist/hip ratio, 76% had increased waist circumference.

CONCLUSIONS: Individual results obtained by both anthropometry and DEXA show diverse patterns of fat gain and loss over 64 weeks after initiation of ART, but changes tended to occur in the same direction. Increased waist/hip ratio was predominantly associated with increased waist circumference. There was no evidence that central fat accumulation and peripheral fat loss are linked in most subjects.

DOI10.1097/01.qai.0000214811.72916.67
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID16652032
Grant List1U01 AI 3844 / AI / NIAID NIH HHS / United States
AI 25897 / AI / NIAID NIH HHS / United States
AI 25903 / AI / NIAID NIH HHS / United States
AI 27664 / AI / NIAID NIH HHS / United States
AI 27668 / AI / NIAID NIH HHS / United States
AI 27670 / AI / NIAID NIH HHS / United States
AI 27675 / AI / NIAID NIH HHS / United States
AI 34832-12 / AI / NIAID NIH HHS / United States
AI 38855 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
M01 RR 05096 / RR / NCRR NIH HHS / United States
RR 00036 / RR / NCRR NIH HHS / United States
RR 00052 / RR / NCRR NIH HHS / United States
RR 00750 / RR / NCRR NIH HHS / United States
U01 AI 025915 / AI / NIAID NIH HHS / United States
U01 AI 025924 / AI / NIAID NIH HHS / United States
U01 AI 25859 / AI / NIAID NIH HHS / United States
U01 AI 27673 / AI / NIAID NIH HHS / United States