Navegando por Assunto "Lipodistrofia"

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Alterações endócrinas e metabólicas em pacientes HIV positivos com lipodistrofia
(Universidade Federal do Pará, 2007-11-30) YAMANO, Ernesto Yoshihiro Seki; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Lipodystrophy is one of the complications of highly active antiretroviral therapies (HAART). This study evaluates the metabolic and endocrine changing in patients with lipodystrophy. Forty patients were evaluated and classified as lipoatrophy, lipohypertrophy and mixed syndrome. We analyzed insulin resistance for HOMA-IR (Homeostasis Model Assesment Insulin Resistance), fasten glucose and OGTT, urea, creatinine, TSH, Free T4, cortisol, DHEA, ratio cortisol/DHEA, prolactin, testosterone (in male), FSH, LH and estradiol (in female), total cholesterol, LDL-c, HDL-c, uric acid. Anthropometrics measures (Weight, height, body mass index, waist, hip and skin folds thickness), ultrasonographic exams for evaluate hepatic steatosis and measure of bone density. The isolated lipohipertrophy occurred only in female (p<0,05). The mean of age was similar in the groups, without changing in the distribution by age group. Dyslipidemia occurred in all groups after HAART (lipodystrophy mixed, 100%, lipohypertrophy, 80% and lipoatrophy, 70%). Antropometric data showed waist increased in the female with lipohypertrophy (98+ 13,4) and decreased in female with lipoatrophy (76,8 + 6,1). Patients with lipoatrophy have been eutrophic (82,4%) and patients with lipohypertrophy have overweight or obesity (60%). Male was associated with osteoporosis (p < 0,05). We found elevated prevalence of the dyslipidemia (85%) and metabolic syndrome (37,5%) in all groups. The metabolic syndrome was associated with lipohypertrophy. No significant changes were found in the thyroid, cortisol, cortisol/DHEA ratio, testosterone, FSH, LH and prolactina. Conclusions: Female is associated with isolated lipohypertrophy, metabolic syndrome and insulin resistance. Male is related with Osteopenia and osteoporosis. Hepatic steatosis were common, but is not influenced for a type of lipodystrophy. Hormonal changing were unusual events in lipodystrophy.
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Avaliação da marcha e do equilíbrio em pacientes portadores de síndrome lipodistrófica secundária à terapia antirretroviral
(Universidade Federal do Pará, 2013-09-25) LIMA, Ramon Costa de; CALLEGARI, Bianca; http://lattes.cnpq.br/0881363487176703; SILVA FILHO, Manoel da; http://lattes.cnpq.br/2032152778116209
The Acquired Immune Deficiency Syndrome (AIDS ) is a disease that devastates the world's population decades and hear this diagnosis was like a " death sentence " . With the advent of new drug therapies, characteristic of the acute disease has become a chronic condition . However , the drugs used in antiretroviral therapy (ART ) have adverse reactions , especially when the patient is subjected to long-term use of so-called "cocktail " . One of the side effects of ART is lipodystrophy , which causes the molecular scale adpócitos apoptosis and mitochondrial alterations in the muscle fibers . Thus, the objective of this study was to investigate the effects of muscle Lipodystrophy and changing patterns of gait and balance of patients in this clinical contexto. Were evaluated 38 subjects of both sexes, divided into two groups: HIV positive with lipodystrophy (HIVL) and HIV positive without lipodystrophy (HIV). The balance test was used a force platform (EMGSystem of Brazil), which evaluates the displacement of the pressure Center (Cop) in the anteroposterior directions (AP) and mediolateral (ML) of the individual generating the variables the total linear displacement, total area of displacement and displacement velocity amplitude of the displacement at a time of sixty seconds for each collection. For the gait test we used the 8-channel Electromyograph (EMGSystem of Brazil) to capture the electrical signals of the muscles Rectus Femoral (RF), biceps femoral (BF), gastrocnemius Lateral (GL), anterior tibialis (TA) and Gluteus Médius (GMD) during ambulation and processing of electromyographic signal was made through the mathematical model Root Mean Square (RMS), and normalized by maximum voluntary contraction (MVC). The results of each group were expressed as mean and standard deviation and compared using the Student t test for parametric samples and the Mann-Whitney test for nonparametric samples. Analysis of the results in the two phases of the gait cycle showed significant differences. In the phase of support and swing phase electromyographic signals of GMD and TA muscle were higher in HIVL group for HIV group. As for the balance variables with statistical significance when comparing the groups were the total displacement and displacement area, both higher in HIVL group for HIV group. Thus we conclude that patients with lipodystrophy syndrome showed changing patterns of gait and balance.
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Avaliação das anormalidades do metabolismo mineral ósseo em pacientes portadores de lipodistrofia e HIV positivos
(Universidade Federal do Pará, 2012-03-21) OLIVEIRA, Danielle Lima de; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
The advances in antirretroviral therapy (HAART) markedly suppressed viral activity and increased longevity of those living with HIV / AIDS, however, a variety of metabolic abnormalities related to treatment was reported after the introduction of HAART combined among these complications, changes in bone mineral density arouse special attention, not only for its long-term implications, but also by the conflicting data available in the literature. OBJECTIVES: to evaluate changes in bone mineral density, and correlate them with sex, age, body mass index body, types of lipodystrophy, laboratory levels of serum calcium, parathyroid hormone and vitamin D and hormonal profile. METHODS: in this cross-sectional study 77 HIV patients with lipodystrophy syndrome treated with highly active antirretroviral therapy (HAART), and enrolled in the clinic lipodystrophy of the João de Barros Barreto University Hospital. The clinical examination of patients involved the measurement of weight, height and waist circumference. Laboratory tests performed included measurement of serum calcium, vitamin D, parathyroid hormone, estradiol, testosterone.Patients were divided into three groups according to the form of lipodystrophy: mixed, atrophic and hypertrophic. RESULTS: most patients were male, and the predominant form of lipodystrophy was mixed form. The mean time of infection after HIV diagnosis was 10.98 ± 6.03 years. The prevalence of osteopenia was 61.03% and osteoporosis was 25.97%. The male patients presented more frequently osteoporosis in femoral neck and the female patients in the lumbar spine. Osteoporosis in the lumbar spine was more prevalent in the mixed form of lipodystrophy and the femoral neck and shown to be similar between the atrophic and mixed forms of lipodystrophy. And the frequency of osteoporosis was present in all sequences of age in males and in females only after 50 years. CONCLUSIONS: the prevalence of osteoporosis increases with age in females. There was no association between BMD and the form of lipodystrophy.
Acesso aberto (Open Access)
Avaliação do polimorfismo genético das apolipoproteínas A1 e A5 em pacientes HIV positivos com síndrome lipodistrófica no estado do Pará
(Universidade Federal do Pará, 2012-06-13) DUTRA, Claudia Daniele Tavares; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Introducion: Dyslipidemia is one of the metabolic changes caused by using antiretroviral therapy (ART) in HIV patients with lipodystrophy syndrome. Objective: To evaluate the genetic polymorphisms of apolipoproteins A1 and A5 in HIV patients with lipodystrophy in use of antiretroviral therapy and its association with dyslipidemia. Methods: It´s a cross-sectional and analytical study. We used a research protocol which studied conditions sociodemographic, clinical risk factors (physical activity, smoking, drinking, food frequency) for dyslipidemia, and biochemical assessment of the apolipoproteins A1 and A5 polymorphisms. Results: Of the 105 HIV-positive patients studied, 63.8% were men, mean age of 44.5 (± 9.4) years, 70.5% reported being single and having a family income of up to three minimum wages (77,1%). The risk factors were: smoking (21%), alcohol use (43.8%), physical inactivity (69.5%), diabetes mellitus (16.2%), overweight (22.9%) and cardiovascular risk (39.1%). The most prevalent form of lipodystrophy syndrome was mixed (51.4%). Food frequency intake observed of fruits (60.8%) and vegetables (36.3%), milk and dairy products (75%) were daily. While candy and sweets (31.4%), sausages (11.7%) and fatty snacks (26.4%) were more than twice a week. And the habit of eating meat with fat apparent was common (56.9%). The observed dyslipidemia classification revealed most patients with isolated hypertriglyceridemia (30.5%) and mixed hyperlipidemia (32.4%). It was observed that the isolated hypertriglyceridemia associated with the apolipoprotein A5 gene (rs3135506, rs619054 and rs662799), and not being influenced by clinical forms of lipoatrophy. There was no presence of the apolipoprotein A1 polymorphism (Lys107-0must2) in the patients studied. Conclusion: The main factors for hypertriglyceridemia were being man and had apolipoprotein A5 gene polymorphisms (rs3135506, rs619054 and rs662799).
Acesso aberto (Open Access)
Avaliação do risco cardiovascular em pacientes com lipodistrofia secundária a terapia antirretroviral: critérios de framingham, índice tornozelo-braço e medida da espessura da camada medio-intimal da carótida
(Universidade Federal do Pará, 2011-12-16) KOURY JUNIOR, Adib; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
The use of combination antiretroviral therapy has significantly reduced mortality and morbidity in patients infected by HIV virus. However, this treatment may cause metabolic alterations such as dyslipidemia, glucose intolerance, insulin resistance and lipodystrophy. The clinical and laboratorial consequences that follow these alterations may raise the risk for cardiovascular diseases. This research aimed to investigate the epidemiological, clinical and laboratorial aspects of patients with lipodystrophy associated to raise cardiovascular risk, ankle-brachial index (ABI) and measurement of the carotid intima-media thickness (cIMT). For so, it was performed a Transversal analytical study with 62 patients with lipodystrophy using highly active antiretroviral therapy (HAART) with ages varying from 29 to 68, followed up in the outpatient unit of lipodystrophy of João de Barros Barreto University Hospital. The patients were submitted to anamnesis with clinical examination, blood collection for laboratorial tests with glycemia dosage, total cholesterol and its fractions, triglycerides and ultrasensitive PCR, measurement of the ankle-brachial index and measurement of the carotid intima-media thickness through mode B ultrasonography. The patients were classified according to their cardiovascular risks through the criteria of the Framingham Score. The variables were analyzed by the study of the measurements of central trend and the hypotheses were analyzed by the chi-square Test and/or the Fisher exact Test. The prevalence of alteration of the ABI in the studied sample was 21% and of the patients with a increase of the cIMT was 48.4%. According to the Framingham score, 53.2% of the patients presented low risk to a cardiovascular event in a 10 year range, 16.1% of moderate risk and 30.7% of high risk. A patient with a increase of the cIMT presented a larger cardiovascular risk through the Framingham score. Male, age, increase of the abdominal circumference have presented a significant association with the carotid intima-media thickness cIMT.
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Fatores clínicos e laboratoriais da doença pelo HIV na composição corporal, força muscular, nível de atividade física, lipodistrofia e sua repercussão na qualidade de vida
(Universidade Federal do Pará, 2014-11-28) SILVA, Luiz Fernando Gouvêa e; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
The aim of this study was to analyze the association between clinical and laboratory factors of HIV disease on body composition, muscle strength, physical activity levels, the lipodystrophy syndrome and the influence of these factors on the quality of life of patients. The sample consisted of 219 HIV-infected patients, outpatients of the municipality of Santarem - PA. Sociodemographic information, clinical and laboratory profiles of the patients were collected as well as evaluations according to body composition, grip strength, physical activity levels, lipodystrophy and quality of life. Data were analyzed descriptively and inferentially, through the facilities of the software Graphpad Prism 3.0 and BioEstat 5.0, adopting a significance level of p <0.05. Sociodemographic results showed a higher frequency in males (59%), aged 28-37 years (35.2%), eight years of schooling or more (67.6%), parda ethnicity (73%), civil singleness (50.2%), income equal to or less than 2 minimum wages (76.8%), unemployed (17.1%). Clinically, most patients were on ART (89%) had a diagnosis of Aids (51.1%), diabetes was most frequent among the comorbidities (40%), tuberculosis between the co-infections (32.56%) and toxoplasmosis among other infections (51.43%), the most commonly used regimen was AZT/3TC/EFV (43.2%) and mixed lipodystrophy predominated (44.6%). It was observed that regimen AZT/3TC/LPV-r decreases muscle mass, arm muscle area (AMA) and dominant force in relation to the scheme consisting of AZT/3TC/EFV. Regarding associations, note that BMI was associated with the time of HIV infection, the percentage of fat related to gender and income, lipodystrophy with age, use of ART, time of infection and ART, the circumference of the abdomen (CAb) with gender, age, education, duration of infection and ART, the waist-hip ratio (WHR) with age, education and time to ART. For biochemical, immunological and hemoglobin markers was no association between BMI and glucose and triglyceride, percentage fat with total cholesterol and triglycerides, lipodystrophy with viral load, triglyceride and total cholesterol, the CAb with viral load, triglyceride and hemoglobin, WHR with glucose, triglyceride and total cholesterol. The AMA was higher in patients without IP in the ART regimen, with time of infection above 50 months and in males. The strength of the dominant and non-dominant handgrip were higher for males, not brown, not using IP in ART and normal concentration of hemoglobin. In addition, patients aged 60-68 years showed values of dominant and non-dominant force lower than other age groups. According to quality of life was observed lower scores for concern related to confidentiality and financial, were the largest ever with professional confidence and concern about medication. We can concluded that the presence of lipodystrophy, inadequate CAB and WHR caused changes in total cholesterol and triglyceride. Time of HIV and high ART positively associated with lipodystrophy, changed CAB and WHR. The active patients showed better scores for the overall function, life satisfaction, concerns about confidentiality and the overall average scores compared to inactive.
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Níveis de TNF-α e seu polimorfismo genético em pacientes HIV positivos, portadores de lipodistrofia e em uso de terapia anti-retroviral
(Universidade Federal do Pará, 2008) PINHEIRO, Miguel Corrêa; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
This work presents the results of the research entitled Levels of TNF-α and its Genetic Polimorfism in Patient Positive HIV, Bearers of Lipodistrophy and in Use of Anti-retroviral Therapy. It was aimed at, through the research for now presented, to study the levels serics of TNF-α and its Genetic Polymorphism in Patient Positive HIV, Bearers of lipodistrophy and in Use of Anti-retroviral Therapy. The need of know better the factors involved in the development of a syndrome clinic known as lipodistrophy justifies that aims, considered an adverse effect of the anti-retroviral therapy, so that that knowledge oportunize the reliable of a safe therapeutic regime, propitiating, in that way, a possible improvement in the quality of the patients' life. The methodology undertaken for the quantitative determination of the serics levels of TNF-α it was used of the ELISA method, while, tends in view the research of the occurrence of the polymorphism, it was used of the reaction of PCR for the extraction of DNA, followed by the digestion for the restriction enzyme Ncol. Forty patients participated of the present researches, which 26 were male and 14 were female. In this patient, the dosing of the TNF-α levels was proceeded, as well as it researches of the presence or absence of the genetic polymorphism (-308A).
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Nível de atividade física e síndrome lipodistrófica em pacientes com HIV/Aids
(Universidade Federal do Pará, 2016-04) SILVA, Luiz Fernando Gouvêa e; SAID, Renato do Carmo; KIETZER, Kátia Simone; FREITAS, Jofre Jacob da Silva; XAVIER, Marília Brasil
Introduction: Physical activity can be an ally to minimize the appearance of lipodystrophy and its deleterious effects. Objective: To analyze the relationship between physical activity level (PAL) and lipodystrophy syndrome with body composition and quality of life (QOL) of patients with HIV/Aids. Methods: The study included 120 patients with HIV/Aids (38.55±11.47 years). They were evaluated for body mass index, body composition, basal metabolic rate, waist-hip ratio, QOL, presence, type, and location of lipodystrophy, hand grip strength, and PAL. Results: It was found that 70% were sedentary; in addition, lean body mass was 9.5% higher in active patients, as well as muscle strength of right hand grip (11%) and left hand grip (12%) and basal metabolic rate (6.9%). Regarding the association between QOL and PAL, a weak correlation was noted only in relation to confidentiality (r=0.2160, p=0.0210), and active patients showed better results than sedentary ones (p<0.05). Of the patients with lipodystrophy, 66% were sedentary; the predominant type was mixed lipodystrophy (46%) and the most common regions were face and abdomen. It is noteworthy that in patients without the syndrome, the basal metabolic rate was higher (p=0.0175) and the time of infection (p=0.0020) and HAART (p=0.0002) were lower. Conclusion: We conclude, according to the methodology, that sedentary life was predominant, PAL showed positive association only with the concern with confidentiality and the sedentary patients showed two domains below the score of 50 (financial concern and confidentiality), in relation to one domain of active patients. Lipodystrophy was present in 37% of the sample, being the most prevalent type the mixed lipodystrophy, and the main sites of occurrence were face and abdomen. For this group PAL was not positive for body composition and the presence of lipodystrophy did not influence QOL.
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Perfil metabólico e nutricional de pacientes HIV positivos com lipodistrofia submetidos à terapia anti-retroviral: orientação nutricional
(Universidade Federal do Pará, 2008-04-24) DUTRA, Cláudia Daniele Tavares; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Adverse effects of the lipodystrophyca syndrome is common in patients submitted to the use of highly active anti-retroviral therapy (HAART). This study evaluates the effectiveness of nutritional guidance on the metabolic changes in patients with lipodystrophy secondary to TARV, in the city of Belém - PA, in the period October 2006 to December 2007. We evaluated 29 patients, aged from 20 to 60 years, of both sexes, HIV positive, with lipodystrophyca syndrome, use of HAART and analyzed the metabolic and nutritional alterations before and after the intervention clinical-nutrition. The results were analyzed through programmes BioEstat 4.0 with p<0.05 and Virtual Nutri 1.0. We analyzed total cholesterol and fractions (LDL and HDL), triglycerides, insulin resistance, anthropometric measurements, measure of bone density, assessment of hepatic steatosis and cardiovascular risk. There was greater prevalence of patients retirees, male, aged 41 to 50 years and income from zero to three minimum wages. There were no significant differences between the sexes as to alcoholism and smoking, while 72% of patients not practiced physical activity. The association between lipoatrophy and lipohypertrophy and time of use of HAART, was significant, regardless of sex. There is total cholesterol and high triglycerides, low HDL and LDL normal. The analysis of the metabolism of carbohydrates, 48% of patients had changes glicêmicas and 34% resistance to insulin. It was observed that 52% of patients had hepatic steatosis and 79% change in bone mineral density, with greater prevalence for men. The syndrome presented lipoatrófica global measures smaller than the syndrome and mixed lipohipertrófica. After intervention clinical and nutritional changes significant decrease in levels of triglycerides and glucose and increase of HDL. As for cardiovascular changes, 31% of patients reduced the absolute risk of heart attack and death in 10 years, with reduction of total cholesterol and HDL. The nutritional intervention had a significant decrease in food intake of calories, proteins and lipids. Nutrition treatment minimized the metabolic changes of HAART, providing a better prognosis and quality of life of these patients.