What Is Lipodystrophy?

What Is Lipodystrophy?

Advertisement

Lipodystrophy means abnormal fat changes. It is used to describe a number of unwanted changes in body fat that are experienced by many HIV+ people. Lipodystrophy can also include changes in fat and sugar levels in the blood of HIV+ people.

Although there is no official definition of lipodystrophy in HIV, it is generally broken down into two categories:

• Body shape changes -- Includes fat loss (lipoatrophy) and fat gain (lipohypertrophy) or redistribution in particular areas of the body
• Metabolic complications -- Includes increases in fats and sugars in the blood

HIV+ people can experience both body shape changes and metabolic complications. This is sometimes called lipodystrophy syndrome.

Body Shape Changes

Changes in the way your body looks are caused by fat loss or build up.

Fat loss may happen in the:

• Arms and legs (fat loss may cause bulging veins in the arms and legs)
• Buttocks
  
• Face (sunken cheeks)
  

Fat build up may happen in the:

• Stomach
• Breasts
• Back of the neck ("buffalo hump")
• Round lumps of fat may appear under the skin (lipomas)
  

Some studies show that lipodystrophy affects men and women differently. Women are more likely to see fat gain in their breasts and stomachs while men are more likely to see fat loss in their legs, arms, buttocks, or faces. However, many men and women suffer from both symptoms. It is not clear why there might be differences based on sex. It might have something to do with hormones or with how men and women burn fat differently.

Lipodystrophy can dramatically change your appearance. These changes can leave some people with feelings of poor self-image and low self-esteem. Some people may want to stop taking their HIV drugs. Others may put off treatment due to fear of experiencing lipodystrophy symptoms. You should talk to your health care provider if you are feeling this way.

Metabolic Complications

Changes in fat (lipids) and sugar (glucose) in your blood are called metabolic complications and include:

• Increased lipids in your blood such as cholesterol and triglycerides (hyperlipidemia)
• Increased glucose levels (hyperglycemia)
• Insulin resistance or diabetes
• Increased lactic acid in your blood (lactic acidosis)
  

Metabolic changes cannot be seen without lab tests, but can cause serious long-term health problems.

• Increased levels of cholesterol and triglycerides can put you at a higher risk of developing heart disease or having a heart attack or stroke.
• Increased glucose and insulin levels greatly increase the chance of developing diabetes, a disease that can cause vision and kidney problems and may be life threatening.
• Increased lactic acid can lead to a rare but dangerous condition called lactic acidosis. Symptoms include nausea, vomiting, or stomach pain; feeling very weak and tired; and shortness of breath.

Be sure your health care provider is ordering regular lab tests to monitor you for metabolic complications. Call your health care provider right away if you are experiencing symptoms of lactic acidosis.