Risk Factors for HIV-Associated Lipodystrophy in Men and Women Open Access

Abstract

Purpose: The aim of this analysis was to evaluate the prevalence and risk factors for HIV-Associated
Lipodystrophy Syndrome (HALS) in the Study to Understand the Natural History of HIV/AIDS in the Era of
Effective Treatment (SUN Study).
Methods: The SUN study is Data collected at baseline was used for this analysis. HALS was defined using
both Fat Mass Ratio in males and females and Lower Limb to Trunk Fat Ratio (LLTFR) in males only.
Univariate analysis was performed using MH test statistics. Multivariate analysis was performed using
Poisson regression to estimate Prevalence Ratios (PR).
Results: Population prevalence was 13% using FMR and 38% using LLTRF to define HALS. In females,
only aerobics and having taken stavudine were significant in the final model. In males, using FMR to
define HALs, risk factors included white non-Hispanic (2.32) and Hispanic (PR 2.49) compared to black
non-Hispanic, decreased adiponectin (2.11), use of testosterone (1.87), current smokers (0.51), having
taken ziduvodine (1.53), having taken stavudine (2.12), and increased age (PR 1.69 per 10 year increase)
were all significant. In males, using LLTRF to define HALS, model was similar but dropped testosterone
and smoking status.
Conclusions: FMR did not provide a useful HALS definition for model building in females, but did appear
to be associated with expected risk factors in males. LLTRF was similar in males, but generally provided
measures of association closer to the null. White non-Hispanic and Hispanic races appear to be at an
increased risk for HALS. Lack of temporal data limits causal interpretation of models, however several
traditional risk factors, such as age and HAART therapy, were confirmed while several new risk
associations, such as race and a seemingly protective effect of current smoking status, were identified.

Risk Factors for HIV-Associated Lipodystrophy Syndrome in Men and Women
B.S. Environmental Science
University of Southern California
2006
Thesis Committee Chair: Paige Tolbert, Ph.D.
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Science in Public Health in
Environmental Health/Epidemiology
2012

Table of Contents

Table of Contents

Background









1

HIV-Associated Lipodystrophy Syndrome




1

Health Impacts of HALS






3

Causes and Risk Factors






5

Methods









14
Results









18

Population Characteristics






18


Table 1: Study Population Characteristics by Gender


19
Univariate Analysis







20


Table 2: Univariate (unadjusted) Analysis for Associations Between
HALS (Defined using FMR and LLTFR) in Males and Females
21

Multivariate Analysis






23

Table 3: Multivariate (adjusted) Analysis for Associations Between
HALS (Defined using FMR and LLTFR) in Males and Females
24

Discussion









25

Acknowledgements







30

References









31

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Environmental Health
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Biology, Virology
Keyword	HIV HAART Lipodystrophy SUN study Adipokine
Committee Chair / Thesis Advisor	Tolbert, Paige, Emory University
Committee Members	Patel, Pragna, CDC
Partnering Agencies	CDC

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