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2322390 
Journal Article 
Clinical and metabolic presentation of the lipodystrophic syndrome in HIV-infected children 
Jaquet, D; Lévine, M; Ortega-Rodriguez, E; Faye, A; Polak, M; Vilmer, E; Lévy-Marchal, C 
2000 
Yes 
AIDS
ISSN: 0269-9370
EISSN: 1473-5571 
14 
14 
2123-2128 
English 
11061653 
WOS:000089981100008 
OBJECTIVE: To investigate body fat distribution and glucose and lipid metabolism in HIV-infected children with the aim of describing the lipodystrophic syndrome in children.

DESIGN: Cross-sectional study including 39 HIV-infected children aged 3-18 years.

MAIN OUTCOME MEASURES: Clinical lipodystrophy was defined as peripheral fat wasting (facial and/or buttock and/or limb atrophy with arm skinfold thickness lower than the third percentile of the reference values for sex and age) and/or truncal adiposity (breast enlargement and/or buffalo neck and/or relative abdominal obesity with trunk : arm skinfold ratio > 2 standard deviations). Fasting serum lipid concentrations were measured and an oral glucose tolerance test was performed.

RESULTS: Of 39 HIV-infected children, lipodystrophy was observed in 13 children (33.3%): eight with truncal lipohypertrophy, three with peripheral lipoatrophy and two with combined lipodystrophy. Combined lipodystrophies were observed only in adolescents with a more severe presentation than in prepubertal children. Lipodystrophic children had higher fasting insulinaemia (7.0+/-8.5 versus 3.0+/-2.3 microU/ml; P = 0.07), suggesting a certain degree of insulin-resistance. Hypercholesterolaemia (23% versus 15%; P = 0.59 ) and hypertriglyceridaemia (15% versus 11%; P = 0.76) were observed with the same proportion in the lipodystrophic as in the non-lipodystrophic groups; 23% of the non-lipodystrophic children had dyslipidaemia.

CONCLUSION: The lipodystrophic syndrome prevails in HIV-infected children in the three clinical forms initially described in adults but appears less severe before the initiation of puberty. Insulin-resistance occurs in lipodystrophic children only, whereas dyslipidaemia exists in non-lipodystrophic children as well, suggesting that dyslipidaemia could reflect subclinical alteration of the adipose tissue. 
HIV; lipodystrophic syndrome; children; body fat distribution; glucose metabolism; lipid metabolism