Poster Topical Area: Obesity
Location: Hall D
Poster Board Number: 632
Objectives: to evaluate the prevalence of fat redistribution and cardiovascular risk in HIV-infected patients on HAART.
Methods: We measured weight and height and calculated body mass index (BMI). We also measured circumferences (waist and hip) and performed the clinical evaluation to identify fat redistribution/lipodystrophy. To evaluate cardiovascular risk, we conducted exams of electrocardiogram, stress electrocardiography, pressure arterial hypertension, lipid biochemical tests and blood glucose. We also calculated Framingham Risk Score (FRS). To evaluate the performance of anthropometry to predict cardiovascular risk we used ROC curves.
Results: Among the 448 patients (46.4% females and 53.6% males) with a mean age of 44.13 (± 9.93) years, 30.13% were overweight and 18.96% were obese. Abdominal lipohypertrophy was present in the majority (59.15%) of the patients (females: 82.69% and males: 38.75%, p<0.05). The leg was the region most affected by lipoatrophy in both genders (males: 26.6% and females: 23.0%) and the thorax was the region with the lowest prevalence of lipohypertrophy for both too (males: 2.5% and females: 9.1%). The most prevalent metabolic changes were reduced HDL (66.29%) and hypertriglyceridemia (45.98%). According to the FRS, 154 (34.36%) patients had an increased absolute risk of infarction in 10 years. Waist circumference (WC) showed an excellent performance (better than BMI) to identify cardiovascular risk (area under the ROC curve: 0.83 and 0.86 for males and females, respectively).
Conclusions: The high prevalence of body fat redistribution (with central gain and peripheral loss) and metabolic changes highlight the importance of early nutritional intervention to prevent cardiovascular complications in HIV patients. WC had an excellent performance to identify cardiovascular risk, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely.
Faculty of Medicine of Ribeirao Preto, University of Sao Paulo
Ribeirao Preto, Sao Paulo, Brazil