1. Multidisciplinary Approach to the Treatment of Metabolic and Morphologic Alterations of HIV-Related Lipodystrophy
- Author
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Nicola Squillace, Vanni Borghi, A. Spaggiari, Bruno Bagni, Cristina Aldrovandi, Maria Grazia Amorico, Giorgio De Santis, Maria De Paola, D. De Fazio, Gabriella Orlando, Marco Bertolotti, Alberto Roverato, Giulia Nardini, M. Vandelli, Barbara Beghetto, Costantino Bertucelli, Antonio Pedone, Giovanni Guaraldi, Roberto Esposito, Guaraldi G., Orlando G., Squillace N., De Santis G., Pedone A., Spaggiari A., De Fazio D., Vandelli M., De Paola M., Bertucelli C., Aldrovandi C., Nardini G., Beghetto B., Borghi V., Bertolotti M., Bagni B., Amorico M.G., Roverato A., and Esposito R.
- Subjects
Adult ,Counseling ,Male ,medicine.medical_specialty ,lipodystrophy ,Anti-HIV Agents ,antiretroviral therapy ,Physical exercise ,Gastroenterology ,Insulin resistance ,Waist–hip ratio ,Internal medicine ,Diabetes mellitus ,medicine ,Body Fat Distribution ,Humans ,Pharmacology (medical) ,Surgery, Plastic ,Exercise ,Lipoatrophy ,Apolipoproteins B ,Waist-Hip Ratio ,business.industry ,HIV-Associated Lipodystrophy Syndrome ,Hypertriglyceridemia ,HIV ,Feeding Behavior ,Middle Aged ,Anthropometry ,medicine.disease ,Combined Modality Therapy ,Cholesterol ,Glucose ,Treatment Outcome ,Infectious Diseases ,Endocrinology ,Female ,Lipodystrophy ,business - Abstract
Treatment for metabolic and morphologic alterations in HIV-related lipodystrophy include medical therapy, physical exercise, and surgical interventions.We assessed the efficacy and safety of a comprehensive multidisciplinary approach for treating morphological and metabolic alterations of the lipodystrophy syndrome in consecutive patients attending the Metabolic Clinic (MC) of the University of Modena and Reggio Emilia who had at least 2 evaluations over a 48-week period. 245 patients were evaluated: 143 (62.4%) were men, 74 (36.1%) presented with lipoatrophy, 10 (4.9%) with fat accumulation, 93 (45%) with mixed forms, 24 (11.3%) had hypercholesterolemia (LDL160 mg/dL), 87 (38%) had hypertriglyceridemia (TG150 mg/dL), 13 (5.7%) had diabetes (glucose126 mg/dL), and 78 (44%) had insulin resistance (HOMA-IR4).At follow-up, a significant improvement was observed in both objective and subjective variables. Anthropometric improvement was observed in waist to hip ratio, waist circumference, and right and left cheek dermal thickness measurements. A nonsignificant improvement was observed in fat and lean regional mass by DEXA; CT showed improvement in visceral and subcutaneous adipose tissue. Glucose, HOMA-IR, total cholesterol, and APO B improved. Subjective variables improved in aesthetic satisfaction.We conclude that the medical and surgical interventions proposed in this multidisciplinary therapeutic approach are efficacious and safe in the management of lipodystrophy.
- Published
- 2006