PubMed · 9839336
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
B A Blunt. DXA technologists: educate yourselves.. https://pubmed.ncbi.nlm.nih.gov/9839336/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
OBJECTIVE: To determine if long-term improvement in HIV lipoatrophy can be attained by substitution of thymidine analogues zidovudine (ZDV) or stavudine (d4T) with abacavir (ABC). DESIGN: Long-term follow-up (104 weeks) of a randomized, open-label study. SETTING: Seventeen ambulatory HIV clinics in Australia and London. SUBJECTS: Patients with HIV lipodystrophy were randomized to switch from a thymidine analogue to ABC, while continuing all other antiretroviral therapy (ABC arm) (n = 42) or continue current therapy (ZDV/d4T arm) (n = 43). INTERVENTION: At week 24, all control patients could switch to ABC. Of the original 111 patients randomized, 85 had long-term follow-up data, with 77 having imaging data available at 104 weeks. MAIN OUTCOME MEASURE: The primary endpoint was time-weighted change in limb fat mass, measured by dual-energy X-ray absorptiometry (DEXA). RESULTS: At week 104, the mean increase in limb fat for the ABC and ZDV/d4T group was 1.26 +/- 2.02 kg and 0.49 +/- 1.38 kg, respectively. The time-weighted change for limb fat was significantly different between the two arms (0.43 kg; P = 0.008). On-treatment analysis demonstrated a trend for increased limb fat in patients in the ABC arm. Visceral fat accumulation, buffalo hump, self-assessed lipodystrophy or the lipodystrophy case definition score (LCDS) did not improve. CONCLUSIONS: In patients with moderate-to-severe lipodystrophy, significant improvements in subcutaneous fat continued over 104 weeks after switching from a thymidine analogue to ABC. Nevertheless, the lipodystrophy syndrome was still evident, indicating additional strategies need evaluating.
Skeletal muscle (SM) is a large and physiologically important compartment. Adipose tissue is found interspersed between and within SM groups and is referred to as intermuscular adipose tissue (IMAT). The study objective was to develop prediction models linking appendicular lean soft tissue (ALST) estimates by dual-energy X-ray absorptiometry (DXA) with whole body IMAT-free SM quantified by magnetic resonance imaging. ALST and total-body IMAT-free SM were evaluated in 270 healthy adults [body mass index (BMI) of <35 kg/m(2)]. The SM prediction models were then validated by the leave-one-out method and by application in a new group of subjects who varied in SM mass [anorexia nervosa (AN), n = 23; recreational athletes, n = 16; patients with acromegaly, n = 7]. ALST alone was highly correlated with whole body IMAT-free SM [model 1: R(2) = 0.96, standard error (SE) = 1.46 kg, P < 0.001]; age (model 2: R(2) = 0.97, SE = 1.38 kg, P < 0.001) and sex and race (model 3: R(2) = 0.97, SE = 1.06 kg, both P < 0.001) added significantly to the prediction models. All three models validated in the athletes and patients with acromegaly but significantly (P < 0.01-0.001) over-predicted SM in the AN group as a whole. However, model 1 was validated in AN patients with BMIs in the model-development group range (n = 11; BMI of >16 kg/m(2)) but not in those with a BMI of <16 kg/m(2) (n = 12). The DXA-based models are accurate for predicting IMAT-free SM in selected populations and thus provide a new opportunity for quantifying SM in physiological and epidemiological investigations.
OBJECTIVE: The present study attempted to find out possible coherence between morphologic characteristics in Pap smears and bone mineral density (BMD) as measured by DEXA. STUDY DESIGN: DEXA measurement (with the result expressed as T-score) was performed in 79 women in whom Pap smears for routine cervical cancer screening were obtained. The smears were grouped into atrophic and mature cell patterns. Using astereological analysis, the mean areas of squamous cells, their nuclei and cytoplasm were estimated. RESULTS: The mean areas of cells and cytoplasm were significantly lower at lower T-scores (P < 0.01), while the mean areas of nuclei were not (P > 0.5). T-scores were significantly lower in the atrophic cell pattern group (P < 0.001). The study group indicated concurrently high sensitivity of 80.9% and specificity of 78.1%, with positive predictive value of 84.4%. CONCLUSION: These results suggest that a significant number of women with low BMD could be identified parallel with the routine Pap test for cervical cancer screening without additional costs.