Lipodystrophy in HIV/AIDS: a comparison between physically active, and inactive HIV-infected vs. uninfected men.

Background: Exercise training may reduce whole-body fat mass and percentage. However, whether exercise improves fat distribution assessed by fat mass ratio (FMR) and regional fat percentage in men living with HIV (MLHIV) is still unclear. The aim of this study was to compare the FMR and total and regional body fat between physically active and inactive MLHIV and HIV-uninfected men.

Methods: Using a cross‑sectional design, total and regional body fat assessed by dual x-ray absorptiometry (DXA) were compared between 19 MLHIV (ACT-MLHIV, 52±7 y, 23.8±4.1 kg.m^-2) enrolled in a multimodal training program (aerobic, strength and flexibility exercises) for at least 12 months (60‑min sessions; 3 times/wk with moderate intensity) vs. 19 inactive MLHIV (IN-MLHIV, 51±7 y, 25.9±3.3 kg.m^-2) and 19 HIV-uninfected men (HIV-, 51±8 y, 26.0±3.3 kg.m^-2). FMR was calculated as the ratio between the percentage of fat in the trunk and the lower limbs.

Results: The ACT-MLHIV showed a lower trunk fat percentage (24.1±17.9% vs. 34.4±11.9%; P=0.02) and FMR (1.5±0.6 vs.1.9±0.5; P=0.02) than the IN-MLHIV, with no difference between them in lower limbs fat percentage (IN-MLHIV: 16.3±5.9 vs. ACT-MLHIV: 15.9±9.6%; P=0.98). HIV- showed a lower FMR (1.2±0.2; P<0.02) and superior lower limb fat percentage (24.1±8.0%; P<0.0001) than IN-MLHIV and ACT-MLHIV, as well as a higher total fat percentage than ACT-MLHIV (27.3±6.2 vs. 21.8±6.9%; P=0.02).

Conclusions: Physical exercise seems to attenuate HIV-associated lipodystrophy by reducing trunk fat percentage while preserving lower limb fat mass. FMR and total fat percentage should not be used alone as markers of exercise-induced changes in lipodystrophy.