[Sex influence in lipodystrophy of HIV-infected patients and its association with cardiovascular risk factors]. / Impacto del sexo en el síndrome de lipodistrofia en pacientes con infección por el VIH y su asociación con factores de riesgo cardiovascular.

OBJECTIVE: To evaluate the influence of sex in human immunodeficiency virus (HIV)-infected patients with lipodystrophy and its association with cardiovascular risk factors. PATIENTS AND METHOD: A cross-sectional study was conducted in HIV-infected patients aged 20 or over managed at the outpatient Infectious Disease Unit in 2003. Clinical and epidemiological characteristics of HIV infection, lipodystrophy and cardiovascular risk factors were evaluated. RESULTS: Of the 760 patients included in the study, women comprised 28%. Men with lipodystrophy had a higher prevalence of hypertension, hypercholesterolemia, hypoalphalipoproteinemia and hypertriglyceridemia than those without lipodystrophy. Women with lipodystrophy had a higher prevalence of central obesity and hypertriglyceridemia compared with those without lipodystrophy (22.8 vs. 11.2%, p = 0.000; 20.6 vs. 9.3%, p = 0.001; 39.7 vs. 30%, p = 0.03 y 56.6 vs. 40.9%, p = 0.0001, respectively). The lipoatrophy pattern was predominant in men (24.9 vs. 12.6%, p = 0.0001) and lipoaccumulation forms in women (12.3 vs. 22.6%, p = 0.0001). Furthermore, women were younger, had a higher prevalence of smoking, family history of premature coronary heart disease and central obesity, and a lower prevalence of hypertension and hypoalphalipoproteinemia than men with lipodystrophy (42.1 +/- 8 years vs. 44.8 +/- 9.9 years, p = 0.03; 77.5 vs. 64%, p = 0.04; 22.5 vs. 9%, p = 0.003; 31 vs. 8.5%, p = 0.0001; 9.9 vs. 22.8%, p = 0.01; 25.4 vs. 39.7%, p = 0.03). CONCLUSIONS: This study demonstrated that the influence of sex in lipodystrophy in HIV-infected patients affects not only the lipodystrophy pattern, but also the cardiovascular risk profile.

Impacto del sexo en el síndrome de lipodistrofia en pacientes con infección por el VIH y su asociación con factores de riesgo cardiovascular / Sex influence in lipodystrophy of HIV-infected patients and its association with cardiovascular risk factors

Objetivo: Evaluar el impacto del sexo en la presencia del síndrome de lipodistrofia en una población de pacientes infectados por el VIH y su asociación con los factores de riesgo cardiovascular. Pacientes y método: Estudio transversal que incluyó a los pacientes de 20 años de edad o mayores, con infección por el VIH atendidos en la consulta externa del Servicio de Medicina Interna y Enfermedades Infecciosas del Hospital del Mar de Barcelona durante el año 2.003. Se evaluaron las características clínico-epidemiológicas de la infección por el VIH, la presencia de lipodistrofía y los factores de riesgo cardiovascular. Resultados: De los 710 pacientes incluidos en el estudio, las mujeres representaban el 28% de la serie. Los varones con lipodistrofia presentaron una mayor prevalencia de hipertensión arterial, hipercolesterolemia, hipoalfalipoproteinemia e hipertrigliceridemia comparado con los que no presentaban lipodistrofia (22,8 vs. 11,2%, p = 0,000; 20,6 vs. 9,3%, p = 0,001; 39,7 vs. 30%, p = 0,03 y 56,6 vs. 40,9%, p = 0,0001, respectivamente). En las mujeres, la presencia de lipodistrofia se acompañó de una mayor prevalencia de obesidad central e hipertrigliceridemia con respecto a la ausencia de lipodistrofia. En los varones predominó el patrón de lipoatrofia (24,9 vs. 12,6%, p = 0,0001), y en las mujeres el lipoacúmulo (12,3 vs. 22,6%, p = 0,0001). Además, las mujeres eran más jóvenes, tenían una mayor prevalencia de tabaquismo, antecedentes familiares de cardiopatía isquémica prematura y de obesidad central, y una menor prevalencia de hipertensión arterial y de hipoalfalipoproteinemia que los varones con lipodistrofia (42,1 ± 8 años vs. 44,8 ± 9,9 años, p = 0,03; 77,5 vs. 64%, p = 0,04; 22,5 vs. 9%, p = 0,003; 31 vs. 8,5%, p = 0,0001; 9,9 vs. 22,8%, p = 0,01; 25,4 vs. 39,7%, p = 0,03, respectivamente). Conclusiones: El presente estudio demuestra que el impacto del sexo en la lipodistrofia de los pacientes con infección por el VIH no sólo afecta al patrón de lipodistrofia, sino también al perfil de riesgo cardiovascular

Objective: To evaluate the influence of sex in human immunodeficiency virus (HIV)-infected patients with lipodystrophy and its association with cardiovascular risk factors. Patients and method: A cross-sectional study was conducted in HIVinfected patients aged 20 or over managed at the outpatient Infectious Disease Unit in 2003. Clinical and epidemiological characteristics of HIV infection, lipodystrophy and cardiovascular risk factors were evaluated. Results: Of the 760 patients included in the study, women comprised 28%. Men with lipodystrophy had a higher prevalence of hypertension, hypercholesterolemia, hypoalphalipoproteinemia and hypertriglyceridemia than those without lipodystrophy. Women with lipodystrophy had a higher prevalence of central obesity and hypertriglyceridemia compared with those without lipodystrophy (22.8 vs. 11.2%, p = 0.000; 20.6 vs. 9.3%, p = 0.001; 39.7 vs. 30%, p = 0.03 y 56.6 vs. 40.9%, p = 0.0001, respectively). The lipoatrophy pattern was predominant in men (24.9 vs. 12.6%, p = 0.0001) and lipoaccumulation forms in women (12.3 vs. 22.6%, p = 0.0001). Furthermore, women were younger, had a higher prevalence of smoking, family history of premature coronary heart disease and central obesity, and a lower prevalence of hypertension and hypoalphalipoproteinemia than men with lipodystrophy (42.1 ± 8 years vs. 44.8 ± 9.9 years, p = 0.03; 77.5 vs. 64%, p = 0.04; 22.5 vs. 9%, p = 0.003; 31 vs. 8.5%, p = 0.0001; 9.9 vs. 22.8%, p = 0.01; 25.4 vs. 39.7%, p = 0.03). Conclusions: This study demonstrated that the influence of sex in lipodystrophy in HIV-infected patients affects not only the lipodystrophy pattern, but also the cardiovascular risk profile

[Estimate of the costs of osteoporotic fractures of the femur in Spain]. / Aproximación a los costes de la fractura osteoporótica de fémur en España.

To evaluate the economic impact of osteoporosis, the cost of acute attention to the osteoporotic hip fractures recorded in Barcelona during one year was investigated. The hospital records of 8637 beds (85.64% of the overall number in the city) were reviewed and the cases seen in inhabitants aged 45 years or more during 1984 were included. The cost, days of hospital admission, operations and orthopedic material were recorded. Data from 870 fractures were recovered. During the study period 1358 hip fractures took place in Barcelona, with 1269 +/- 21 (mean +/- SEM) operations, 31219 +/- 1550 (mean +/- SEM) days of hospital admission, and 408 +/- 40 (mean +/- SEM) prostheses. Their attention generated a cost amounting to 662.5 +/- 29.5 (mean +/- SEM) million pesetas. The cost of each fracture was 488200 +/- 331700 (mean +/- SD) pesetas, with a hospital stay of 23 +/- 17 (mean +/- SD) days. This represents, for the whole of Spain, 33298 +/- 1769 (mean +/- SEM) fractures, 31160 +/- 2154 (mean +/- SEM) operations, 767853 +/- 78314 (mean +/- SEM) hospital admission days and 10042 +/- 1530 (mean +/- SEM) prostheses every year. The yearly expenditure is 16295 +/- 1598 (mean +/-SEM) million pesetas (confidence interval of the estimation 95%). Thus, osteoporotic hip fracture results in a significant expenditure in this country. The enormous cost of the attention to osteoporosis and its complications warrants a greater effort for its prevention and care.