Reviewed by: Xin Li (Beijing Ditan Hospital, Capital Medical University)
A fat metabolism disorder is a problem with the way the body synthesizes, uses, and stores fat, also known as abnormal fat distribution.
This disorder is common in older antiretroviral (ART) therapy, with the use of new antiretroviral drugs and better control of HIV infection, reducing the likelihood of fat metabolism disorders.
1, Symptoms
There are two types of fat metabolism disorders: fat reduction and fat accumulation.
Fat reduction is common in men, scientifically known as fat atrophy, and is common in the following parts of patients:
Upper and lower extremities, the veins of these parts will be more pronounced than normal;
the face, which can cause deep depression in the cheeks, temples, or eye sockets;
buttocks.
Fat accumulation is more common in women. Fat accumulation is also known as fat hyperplasia and excessive obesity. Fat accumulation is common in:
abdomen and lower abdomen;
Chest (may also appear in men);
The back neck and shoulders, sometimes called the "buffalo back".
Cellulite hyperplasia may occur in other parts of the patient's body, called lipomas.
Image source: Stand Cool Helo
2. Causes
Older drugs treating HIV infection, such as stavudine and zidovudine, as well as other older protease inhibitors such as indinavir, have been associated with impaired fat metabolism.
And the longer it is used, the higher the risk. New drugs to treat HIV infection, as well as newer protease inhibitors such as darunavir, are less likely to lead to impaired fat metabolism.
The HIV virus itself also has the effect of interfering with the body's fat metabolism. The more severe the degree of HIV infection and the longer the infection, the higher the likelihood that the patient will develop a disorder of fat metabolism.
The likelihood of adipose metabolism disorders is higher in the following conditions:
Elderly;
Caucasians;
Obesity, or significant changes in weight.
It is important to note that fat loss may also be caused by AIDS wasting syndrome.
3. Diagnosis
Diagnosis is confirmed by physical examination. Doctors measure the patient's arm circumference, thigh circumference, waist circumference, hip circumference, and neck circumference as baseline values and record them for comparison with later measurements.
Disorders of fat metabolism are often accompanied by other metabolic problems, such as hypercholesterolemia and insulin resistance. Insulin resistance can lead to diabetes. These diseases, in turn, can lead to other problems, such as an increased risk of heart disease.
So doctors usually check the patient's blood pressure and ask the patient to do a blood test to understand:
Cholesterol levels, including LDL (bad cholesterol) and HDL (good cholesterol);
Triglycerides (a type of blood lipids) level;
Blood sugar levels.
Image source: Stand Cool Helo
4. Treatment
Remember not to discontinue medications for HIV infection. Although the cause of fat metabolism disorders may not be because of these drugs, doctors usually still change the drug combination.
New anti-HIV drugs, such as integrase chain transfer reaction inhibitors, are less likely to lead to disorders of fat metabolism.
Exercising and choosing healthy foods can help increase muscle and reduce fat accumulation. Exercise also improves the body's ability to use insulin. Whether it's aerobic exercise or strength exercise (weight-bearing exercise), it boosts strength and contributes to heart health.
And both reduce belly fat. However, be careful not to lose too quickly when losing weight.
Sometimes patients may need to take medications specifically for disorders of fat metabolism or related disorders, such as:
Timoreline, an injection used daily, reduces abdominal fat but has the potential to cause blood sugar to rise.
Metformin, used to treat hyperglycemia and insulin resistance.
Atorvastatin or rosuvastatin, used to treat high cholesterol.
Other treatments are:
Hormone therapy, such as testosterone and human growth hormone.
Plastic implants.
Injections that increase skin thickness and fill collapsed cheeks.
Surgery to remove accumulated fat.
Image source: Stand Cool Helo
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
*The copyright of this article belongs to Tencent Medical Code, unauthorized media reprinting is prohibited, and illegal reprinting will be investigated for legal responsibility according to law. Individuals are welcome to forward to the circle of friends.
* Welcome to WeChat search and pay attention to the public account "Tencent Medical Code" to get more health science knowledge.