Sonographic Assessment of Regional Fat in HIV-1-Infected People [Martinez E, et al. Lancet 2000;356:1412]: The authors used sonography to measure subcutaneous fat thickness in 60 patients with HIV infection and 60 controls. The sites assessed were intra-abdominal fat thickness and three skin points: periumbilical, brachial, and malar. Lipodystrophy was defined by patient reports and physician confirmation. The results showed that sonographic assessment of subcutaneous fat at the malar and brachial sites were the most sensitive and specific. The value used for brachial fat was <4 mm and for malar fat was <4 mm. This showed a sensitivity of 87% and specificity of 74%.
Comment: There has been considerable controversy about methods to document fat redistribution. The authors here argue that sonography has substantial advantages compared to DEXA, CT, and MRI that include the facts that it is simple, rapid, readily available, harmless, low in cost, and well accepted by patients.
posted 12/6/2000