Comparison of bioelectrical impedance with skinfold thickness and X-ray absorptiometry to measure body composition in HIV-infected with lipodistrophy.

INTRODUCTION: Human immunodeficiency vírus (HIV)-associated lipodystrophy syndrome (LS) includes body composition and metabolic alterations. Lack of validated criteria and tools make difficult to evaluate body composition in this group. OBJECTIVE: The aim of the study was to compare different methods to evaluate body composition between Brazilians HIV subjects with (HIV+LIPO+) or without LS (HIV+LIPO-) and healthy subjects (Control). METHODS: in a cross-sectional analyses, body composition was measured by bioelectrical impedance analysis (BIA), skinfold thickness (SF) and dual-energy x-ray absorptiometry (DXA) in 10 subjects from HIV+LIPO+ group; 22 subjects from HIV+LIPO- group and 12 from Control group. RESULTS: There were no differences in age and body mass index (BMI) between groups. The fat mass (FM) (%) estimated by SF did not correlate with DXA in HIV+LIPO+ group (r = 0,46/ p > 0,05) and had fair agreement in both HIV groups (HIV+LIPO+ =0,35/ HIV+ LIPO- = 0,40). BIA had significant correlation in all groups (p < 0,05) and strong agreement, meanly in HIV groups, for FM (HIV+LIPO+ = 0,79/ HIV+LIPO- = 0,85 / Control = 0,60) and for fat free mass (FFM) (HIV+LIPO+ = 0,93 / HIV+LIPO- = 0,92 / Control = 0,73). DISCUSSION: Total fat mass can be measured by BIA with good precision, but not by SF in HIV-infected patients with LS. Segmental BIA, triciptal SF, circumferences of arms, waist and legs maybe alternatives that need more studies.

Comparison of bioelectrical impedance with skinfold thickness and x-ray absorptiometry to measure body composition in HIV-infected with lipodistrophy / Comparación de impendancia bioeléctrica con grosor de pliegues cutáneos y absorciometría de rayos X para mensurar la composición corporal de personas con VIH con lipodistrofia

Introduction: Human immunodeficiency vírus (HIV)-associated lipodystrophy syndrome (LS) includes body composition and metabolic alterations. Lack of validated criteria and tools make difficult to evaluate body composition in this group. Objective: The aim of the study was to compare different methods to evaluate body composition between Brazilians HIV subjects with (HIV+LIPO+) or without LS (HIV+LIPO-) and healthy subjects (Control).Methods: in a cross-sectional analyses, body composition was measured by bioelectrical impedance analysis(BIA), skinf old thickness (SF) and dual-energy x-ray absorptiometry (DXA) in 10 subjects from HIV+LIPO+group; 22 subjects from HIV+LIPO- group and 12 from Control group. Results: There were no differences in age and bodymass index (BMI) between groups. The fat mass (FM)(%) estimated by SF did not correlate with DXA inHIV+LIPO+ group (r = 0,46/ p > 0,05) and had fair agreement in both HIV groups (HIV+LIPO+ =0,35/ HIV+LIPO- = 0,40). BIA had significant correlation in all groups (p < 0,05) and strong agreement, meanly in HIV groups, for FM (HIV+LIPO+ = 0,79/ HIV+LIPO- = 0,85 /Control = 0,60) and for fat free mass (FFM) (HIV+LIPO+= 0,93 / HIV+LIPO- = 0,92 / Control = 0,73).Discussion: Total fat mass can be measured by BIA with good precision, but not by SF in HIV-infected patients with LS. Segmental BIA, triciptal SF, circumferences of arms, waist and legs maybe alternatives that need more studies (AU)

Introducción: El síndrome de lipodistrofia (SL) asociado al virus de inmunodeficiencia humana (HIV)incluye alteraciones en la composición corporal y metabólica. La falta de herramientas adecuadas y criterios válidos dificultan la evaluación de la composición corporal en este grupo. Objetivo: El objetivo del estudio fue comparar distintos métodos para evaluar la composición corporal entre individuos brasileños con HIV que teniam (HIV+LIPO+) o noLS (HIV+LIPO-) e individuos sanos (control). Métodos: Estudio transversal en el que fue evaluada la composición corporal por análisis de impedancia bioeléctrica (BIA), pliegues cutáneos (SF) y absorciometría de rayos X de doble energía (DXA) en un grupo de 10 individuos con HIV+LIPO+, 22 individuos del grupo HIV+LIPO- y 12 individuos del grupo control. Resultados: No hubo diferencias en la edad e índice de masa corporal (IMC) entre grupos. La masa grasa (MG)(%) estimada por SF no se correlacionó con DXA en pacientes del grupo HIV+LIPO+ (r = 0,46 / p> 0,05) y había leve concordancia en ambos grupos con HIV(HIV+LIPO+ = 0,35/ HIV+LIPO- = 0,40). BIA tuvo una correlación significativa en todos los grupos (p <0,05) y fuerte acuerdo, principalmente en grupos HIV para MG(HIV+LIPO+ = 0,79 / HIV+LIPO- = 0,85 / Control = 0,60) y para la masa libre de grasa (HIV+LIPO+ = 0,93/HIV+LIPO- = 0,92 / Control = 0,73).Discusión: La masa grasa total puede ser medida porBIA con precisión, pero no por SF en los individuos con HIV y LS. BIA segmentario, SF del tríceps, circunferencia de brazos, cintura y piernas, pueden ser alternativas que necesiten más estudios(AU)

Nutritional assessment of vitamin E in malnourished patients with AIDS.

Malnourished patients with acquired immunodeficiency syndrome (AIDS) may have low serum levels and reduced intake of alpha-tocopherol, mainly in the presence of acute-phase response. The aims of this study were to compare intake and serum levels of alpha-tocopherol between malnourished (MN) and non-malnourished (NMN) AIDS patients and to correlate alpha-tocopherol intake and serum levels. Undernutrition was defined as having a body mass index lower than 18. 5 kg/m(2) or a height-creatinine index lower than 70%. A semiquantitative food frequency questionnaire assessed alpha-tocopherol intake. High-performance liquid chromatography determined vitamin serum levels. The patients were divided into MN (n = 14) and NMN (n = 15) groups. There were no statistical differences in relation to clinical findings between MN and NMN, respectively, including moniliasis (7/14 versus 4/15), neurocryptoccocosis and neurotoxoplasmosis (6/14 versus 6/15), pulmonary tuberculosis (4/14 versus 2/15), and fever (1/14 versus 3/15). MN and NMN groups had similar peripheral blood CD(4) levels (111.4+/-87.1 versus 124.4+/-90.9 cells/mm(3)), and both groups had similar and adequate alpha-tocopherol intake (MN = 50.0+/-11.0 versus NMN = 47.2+/-16.5 mg) and serum levels (MN = 17.8+/-7.2 versus NMN = 19.8+/-6.3 micromol/L). Vitamin E intake and serum levels did not show a significant correlation (r = -0.22, P 0.05). Protein-energy nutrition status and acute-phase response were not factors determining vitamin status among AIDS patients.

Hyponatremia in acute-phase response syndrome patients in general surgical wards.

BACKGROUND: In surgical patients, hypoalbuminemia may occur as a component of acute-phase response (APR) syndrome, which we hypothesized could decrease serum sodium levels. AIM: To compare the frequency of hyponatremia in adult surgical inpatients with or without APR syndrome. METHODS: All the simultaneous plasma sodium and albumin results (n = 168), obtained from adults in surgical wards and corresponding to a 6-month period, were searched in the hospital mainframe. Other relevant laboratory and clinical data were also registered. APR was ascertained by the presence of major physical trauma, surgery or infection, plus hypoalbuminemia (serum albumin <3.5 g/dl) and neutrophil left shift (>/=7% of band count) associated with peripheral leukopenia (white blood cells <4, 000/mm(3)) or leukocytosis (WBC >9,000/mm(3)). Hyponatremia was defined by serum sodium concentration <135 mEq/l. RESULTS: APR-positive patients (n = 113) had lower blood hemoglobin (10.92 +/- 2.18 vs. 13.53 +/- 2.30 g/dl), and serum albumin levels (median, range: 2.8, 1.9-3.4 vs. 3.7, 3.5-4.2 g/dl) than APR-negative (n = 55) ones, the same occurring in relation to antibiotics (54.8 vs. 10. 9%) and intravenous 5% dextrose in water (55.7 vs. 20.0%) or isotonic saline (46.0 vs. 9.1%) infusion. The hyponatremia frequency was higher among APR-positive patients (31.0 vs. 10.9%). CONCLUSION: The higher percentage of hyponatremia among APR-positive patients could be attributed to decreased serum albumin levels associated with APR.