Lipodystrophy
CLINICAL
- Obesity is defined by body mass index (BMI) ≥30 kg/m2. In those with low body mass, BMI ranging from 18.5 to 24.9 kg/m2 may represent excess adiposity.[6]
- Cause is multifactorial and includes imbalance between calories consumed and expended, age, genetics, and microbiome alterations.
- Adipocyte plays central role in multisystem disease.[3]
- Lipohypertrophy is localized abnormal fat accumulation: central or visceral adipose tissue (VAT), breast fat, dorso-cervical fat pad (buffalo hump) or lipomas.
- Central adiposity is linked to increased mortality.[9]
- VAT accumulation, as little as 5%, is associated with metabolic syndrome, diabetes, and cardiovascular disease (CVD).[6]
- VAT, intrahepatic fat, and epicardial fat are associated with CVD, independent of traditional CVD risk factors.
- Lipohypertrophy is associated with elevation of inflammatory cytokines.
- Central adiposity is linked to increased mortality.[9]
- Lipoatrophy (LA): peripheral fat loss in face, limbs and buttocks.
- Lipodystrophy: coexisting lipohypertrophy and lipoatrophy with changes in body fat composition based on anthropomorphic measures of fat distribution, such as waist circumference (WC).
- Accompanied by metabolic disorders: dyslipidemia, hypertriglyceridemia, low HDL, insulin resistance, and diabetes mellitus.
- Low frequency (< 5%) with current ART regimens.
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Last updated: October 19, 2022
Citation
Spacek, Lisa A. "Lipodystrophy." Johns Hopkins HIV Guide, 2022. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545121/all/Lipodystrophy.
Spacek LA. Lipodystrophy. Johns Hopkins HIV Guide. 2022. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545121/all/Lipodystrophy. Accessed November 29, 2023.
Spacek, L. A. (2022). Lipodystrophy. In Johns Hopkins HIV Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545121/all/Lipodystrophy
Spacek LA. Lipodystrophy [Internet]. In: Johns Hopkins HIV Guide. ; 2022. [cited 2023 November 29]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545121/all/Lipodystrophy.
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