Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models
Background Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. Methods A cross-s...
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| Vydané v: | BMC public health Ročník 18; číslo 1; s. 806 - 14 |
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| Hlavní autori: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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London
BioMed Central
27.06.2018
BioMed Central Ltd Springer Nature B.V BMC |
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| Abstract | Background
Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.
Methods
A cross-sectional design was employed to recruit 106 PLWHA (me
n
= 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.
Results
Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r
2
= 0.77, SEE = 0.14, r
2
PRESS
= 0.73, SEE
PRESS
= 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education
years
, time of diagnosis to HIV
months
, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r
2
= 0.78, SEE = 0.11, r
2
PRESS
= 0.71, SEE
PRESS
= 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART
months
, body circumference of chest, and race
(Asian)
(“Yes” for Asian race = 1; “No” = 0).
Conclusions
The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. |
|---|---|
| AbstractList | Background
Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.
Methods
A cross-sectional design was employed to recruit 106 PLWHA (me
n
= 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.
Results
Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r
2
= 0.77, SEE = 0.14, r
2
PRESS
= 0.73, SEE
PRESS
= 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education
years
, time of diagnosis to HIV
months
, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r
2
= 0.78, SEE = 0.11, r
2
PRESS
= 0.71, SEE
PRESS
= 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART
months
, body circumference of chest, and race
(Asian)
(“Yes” for Asian race = 1; “No” = 0).
Conclusions
The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. Abstract Background Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. Methods A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model. Results Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2 PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r2 = 0.78, SEE = 0.11, r2 PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) (“Yes” for Asian race = 1; “No” = 0). Conclusions The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013-2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model. Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r = 0.77, SEE = 0.14, r = 0.73, SEE = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education , time of diagnosis to HIV , and type of combined antiretroviral therapy (cART) (with protease inhibitor "WI/PI = 1" or without protease inhibitor "WO/PI = 0"); and model five for women (r = 0.78, SEE = 0.11, r = 0.71, SEE = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART , body circumference of chest, and race ("Yes" for Asian race = 1; "No" = 0). The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.BACKGROUNDBody composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013-2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.METHODSA cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013-2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor "WI/PI = 1" or without protease inhibitor "WO/PI = 0"); and model five for women (r2 = 0.78, SEE = 0.11, r2PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) ("Yes" for Asian race = 1; "No" = 0).RESULTSResults support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor "WI/PI = 1" or without protease inhibitor "WO/PI = 0"); and model five for women (r2 = 0.78, SEE = 0.11, r2PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) ("Yes" for Asian race = 1; "No" = 0).The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA.CONCLUSIONSThe proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA. The association of lipodystrophy with non-communicable disease, especially atherosclerosis, is due to lipodystrophy’s negative effects on lipids and insulin sensitivity, and pro-inflammatory effects on endothelial cells [19, 20]. [...]an earlier diagnosis and treatment for lipodystrophy can prevent or delay the development of some non-communicable diseases, thereby leading to better overall health and well-being of PLWHA, while reducing costs of treatment and premature deaths [21]. [...]we did not find high values for the adjusted R2 for the predictive models in both sexes (data not shown). [...]we conducted the stepwise linear regression including all the anthropometric variables, anthropometric ratios, and additional predictor variables due to their association with lipodystrophy. To date, only France [33], Portugal [34], and Brazil [35, 44] have developed cutoff points for lipodystrophy diagnosis using fat mass ratio by DXA. [...]researchers and other health professionals using our predictive models could adopt the most convenient cutoff point for fat mass ratio by DXA as previously cited, or establish a cutoff point for our models to diagnose and monitor lipodystrophy among people living with HIV/AIDS. [...]the aforementioned risk factors are associated with the development of atherosclerotic cardiovascular disease, [25, 26] reinforcing the importance of an early and accurate diagnosis of lipodystrophy to prevent non-communicable diseases. |
| ArticleNumber | 806 |
| Audience | Academic |
| Author | dos Santos, André P. Machado, Dalmo R. L. Navarro, Anderson M. de Santana, Rodrigo C. Schwingel, Andiara Alves, Thiago C. Venturini, Ana Claudia R. Abdalla, Pedro P. |
| Author_xml | – sequence: 1 givenname: André P. orcidid: 0000-0002-0055-4682 surname: dos Santos fullname: dos Santos, André P. email: andreps@usp.br organization: Interunit Nursing Doctoral Program, College of Nursing of the University of Sao Paulo, Kinesiology and Community Health, University of Illinois – sequence: 2 givenname: Anderson M. surname: Navarro fullname: Navarro, Anderson M. organization: Department of Clinical Medicine, Faculty of Medicine at the University of Sao Paulo – sequence: 3 givenname: Andiara surname: Schwingel fullname: Schwingel, Andiara organization: Kinesiology and Community Health, University of Illinois – sequence: 4 givenname: Thiago C. surname: Alves fullname: Alves, Thiago C. organization: Interunit Nursing Doctoral Program, College of Nursing of the University of Sao Paulo – sequence: 5 givenname: Pedro P. surname: Abdalla fullname: Abdalla, Pedro P. organization: School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo – sequence: 6 givenname: Ana Claudia R. surname: Venturini fullname: Venturini, Ana Claudia R. organization: School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo – sequence: 7 givenname: Rodrigo C. surname: de Santana fullname: de Santana, Rodrigo C. organization: Department of Clinical Medicine, Faculty of Medicine at the University of Sao Paulo – sequence: 8 givenname: Dalmo R. L. surname: Machado fullname: Machado, Dalmo R. L. organization: Interunit Nursing Doctoral Program, College of Nursing of the University of Sao Paulo, School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29945584$$D View this record in MEDLINE/PubMed |
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| Keywords | Lipoatrophy cART Anthropometry Body composition Lipohypertrophy |
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Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this... Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to... The association of lipodystrophy with non-communicable disease, especially atherosclerosis, is due to lipodystrophy’s negative effects on lipids and insulin... Abstract Background Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives... |
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| SubjectTerms | Acquired immune deficiency syndrome AIDS Anthropometry Antiretroviral drugs Antiviral agents Biostatistics Biostatistics and methods Body composition Body measurements Cardiovascular diseases cART Diagnosis Disease Dosage and administration Drug therapy Environmental Health Epidemiology Gender differences Health aspects HIV HIV (Viruses) HIV patients Human immunodeficiency virus Life expectancy Linear models (Statistics) Linear regression models Lipids Lipoatrophy Lipodystrophy Lipohypertrophy Low income groups Medical diagnosis Medical imaging Medical personnel Medicine Medicine & Public Health Metabolism Methods Prediction models Public Health Research Article Risk factors Sexually transmitted diseases STD Vaccine Womens health |
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| Title | Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models |
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