Antropometria como técnica de avaliação quantitativa da gordura troncular de adultos vivendo com HIV

Abstract

Clinical monitoring of trunk fat is an important step in establishing the risk of becoming ill and planning nutritional strategies aimed at improving the quality of life of individuals. Considering the associations observed between metabolic changes and the amount of trunk fat in people living with HIV (PLWH), it is necessary to evaluate this body component. The determination of the amount of fat can be performed by techniques and methods with different levels of sensitivity, specificity, accuracy and clinical practicality. Dual-energy x-ray absorptiometry (DXA) and computed tomography of the abdomen are considered gold standard methods for the quantitative determination of trunk fat. In comparison to alternative techniques, the achievement and maintenance of standard gold methods necessitates longer time-lapsing for execution and are financially infeasible especially for scarce resources Health Services. In order to validate anthropometric information regarding the amount of tricuspid PLWH this study investigated adults living with HIV initially without exposure to antiretroviral drugs (ARVs) and followed them for up to 24 months after exposure to ARVs. The results of this doctoral research were presented through two articles. Article 1 - Systematic review of the literature in five databases, aiming to answer the central question: "Is anthropometry able to correctly measure the body fat of PLWH without the use of ARVs?" The search for information resulted in 969 researches and after the methodological sieve eleven studies were selected. As conclusion it was obtained that the majority of the investigated studies (n = 10) didn´t perform treated the information collected with compatible statistics to what we set out to answer evaluating. The only study evaluated that would answer our central question was performed with 100 patients using ARVs invalidating the response for individuals who didn´t use ARVs. Article 2 - Longitudinal study with the objective of validating anthropometry to quantify the trunk fat of PLWH. Strong correlations (r> 0.8) were observed between the amount of trunk fat measured by DXA and the body fat index (BFI) composed of anthropometric variables in all three different periods of use of ARVs evaluated. With concordance values equal to or greater than 78% among the methods, we obtained and validated four equations using BFI as predictor of truncal fat of PLWH stratified by sex and ARVs exposure. By means of the method of verifying the average differences between the amount of trunk fat measured by DXA and by BFI we conclude that the elaborated equations allowed to evaluate the patients' trunk fat.