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Year : 2015  |  Volume : 18  |  Issue : 5  |  Page : 626-632

Lipoatrophy among patients on antiretroviral therapy in Lagos, Nigeria: Prevalence, pattern and association with cardiovascular risk factors

1 Department of Medicine, College of Medicine, University of Lagos, Idi Araba, Lagos, Lagos State, Nigeria
2 Department of Medicine, LAUTECH Teaching Hospital, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomosho, Oyo State, Nigeria
3 Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Correspondence Address:
S O Iwuala
Department of Medicine, College of Medicine, University of Lagos, Idi Araba, P.M.B. 12003, Lagos
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.154208

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Context: Antiretroviral therapy (ART) is linked with morphologic abnormalities such as lipoatrophy (LA), which may accompany metabolic alterations (dysglycemias, dyslipidemia and insulin resistance) that increase cardiovascular disease risk. LA and its association with metabolic alterations have been infrequently studied amongst Nigerians on ART. Aims: To determine the prevalence, pattern and association of LA with metabolic abnormalities and hypertension among patients on ART attending an ambulatory human immunodeficiency virus clinic in Lagos, Nigeria. Subjects and Methods: A cross-sectional study was carried out among patients on ART using a structured interviewer administered questionnaire. Data obtained included patients and physician's assessment of body fat changes, drug history, blood pressure, body composition assessment using bioelectrical impedance analysis and biochemical evaluation (glucose, lipids). LA was defined clinically. Data were analyzed using IBM SPSS statistical software version 21. Results: A total of 48 (33.1%) of the 145 patients had LA. The face was the most frequently affected body region. Patients with LA with lower body circumferences, skin-fold thickness and body fat (P < 0.05). The frequencies of lipid abnormalities were: Reduced high density lipoprotein-cholesterol (47.1%), elevated total cholesterol (35.6%), reduced low density lipoprotein-cholesterol (19.2%), elevated triglycerides (14.4%). Fasting plasma glucose (FPG)≥6.1 mmol/l and hypertension were present among 9.6% and 40.7% respectively. LA was not significantly associated with the presence of glucose intolerance, dyslipidemia or hypertension (P > 0.05). Conclusions: Lipoatrophy, though commonly encountered in patients on ART in Nigeria was not associated with the presence of dyslipidemia, abnormal FPG or hypertension. Regular monitoring by the physician and increased patients awareness are necessary to reduce its prevalence and impact.

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