United Press International - Thursday, April 22, 1999
Ed Susman

Researchers said today the largest study of the condition -- once considered just a curiosity of treatment with drugs which keep AIDS infection at bay -- show distinct differences in how the fat deposits differ between men and women.

At the 3rd International Conference on HIV Infection and Nutrition in Cannes, France, Dr. Norma Muurahainen, lead author of the "SALSA" study, reported preliminary results that found that most patients who develop the fat redistribution syndrome have increased body fat around the waist.

The syndrome was first reported in February 1998 and was dismissed as a uncommon occurrence associated with protease inhibitor treatment. At that time researchers said the appearance of enlarged abdomens, lumps on the back and neck and loss of fat in legs and arms were acceptable prices for a lifesaving therapy.

But as patients lived longer with those therapies, more reported the condition.

Dr. Brian Gazzard of Chelsea and Westminster Hospital, London, displaying a picture of a man with a fatty facial growth, said, "These conditions are a major concern. Many people will be prepared to stop therapy in order to stop looking like this."

The exact cause of why the fat redistribution occurs remains a mystery.

In her study, Muurahainen, a researcher with Serono Laboratories of Norwell, Mass., where the multicenter SALSA data are collected, described preliminary results from 208 patients who filled out a detailed 19-page questionnaire on various aspects of their body characteristics. The patients' doctors completed a companion questionnaire that ran 16 pages.

"There was close correlation between what the patients thought of their condition and what their physicians confirmed about the syndrome," Muurahainen said, "except for the issue of truncal obesity." In general, she said, doctors and patients had differing viewpoints on what constituted obesity.

She also found:

--85 percent of the patients mentioned inappropriate fat accumulation.

--73 percent of the patients noticed areas of fat depletion.

--60 percent of patients said they had both areas of fat accumulation as well as areas of fat depletion.

The body areas affected:

--93 percent of women and 76 percent of men described fat accumulation around the abdomen.

--74 percent of women and 31 percent of men said they had fat accumulations in the breasts.

--69 percent of men and 53 percent of women said they had lost fat in their limbs. Muurahainen said they often described the fat wasting in the limbs as "seeing my veins pop out."

--60 percent of men and 45 percent of women experienced a loss of fat in their buttocks.

--20 percent of men and 10 percent of women said they developed fat deposits on their back or neck, the so-called Buffalo humps.

The patients' doctors reported that men more frequently had increased blood fat levels than women:

--63 percent of men and 26 percent of women had high levels of triglycerides.

--50 percent of men and 26 percent of women had high cholesterol.

High levels of these fats in the blood are considered risk factors for developing heart disease.

Muurahainen said her observations were just the result of a pilot studies and further work would involve more rigorous sampling. More subjects are being recruited for the study.

In another study, Dr. Julian Falutz of Montreal Memorial Hospital also presented data on differences between men and women with the syndrome.

In his study, 71 of 112 subjects described fat redistribution.

"Women were more likely to have normal fat profiles than men," Falutz said. Two thirds of the 17 women with abnormalities had normal blood fats; none of the 25 men had normal lipids. There were also differences between the sexes on fat accumulation and fat depletion.

He suggested that the differences between men and women might be modulated by hormonal activity.

Another researcher, Marijka Batterham of Royal Prince Alfred Hospital, Sydney, Australia, said dietary fat intake did not appear to play a role in the development of fat redistribution syndrome.
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