Assignment (MPhil)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: The aim of this study was to investigate practical methods of monitoring AIDS related
wasting and lipodystrophy in a resource-poor clinical setting with HIV infected women as
the population group of interest. Measurement of body composition changes using
anthropometry is both cost- and time-efficient. Various different skinfolds were taken and
two different equations (the equations of Pollock et al. (1975) and Durnin and Womersley
(1974) for calculating body fat were used to determine the most promising method or
methods of monitoring body composition changes in a clinical setting.
Detailed anthropometric measurements were performed, as well as selected measurements
for haematological parameters and quality of life (QoL) for a group of 8 participants on
antiretroviral medication (ART group) and 6 participants who were not on treatment (TN
group). New variables namely, intra-abdominal indicator (IAI) and a percent of ideal body
mass to percent of ideal arm circumference ratio (%IBW:%IAC) were investigated as
possible indicators of lipodystrophy. Although measurements were taken at various timepoints,
three specific time-points were chosen for data-analysis for the ART group and two
time points for the TN group. These three time-points were, baseline (on the day of
recruitment for TN participants and within one month before the initiation of treatment for
ART participants), short-term (2 to 12 weeks after treatment initiation or the baseline
measurement or for the ART and the TN participants) and long-term (within one and a half
year of treatment initiation for the ART group).
ART and TN participants did not differ for many variables at baseline. The major
differences between ART and TN were in measured and derived variables of the arm,
especially percent of ideal arm circumference (%IAC) and upper arm fat area (UAFA),
which were significantly lower in the ART group.
CD4+ and QoL improved significantly for the ART participants from baseline to long-term.
This was not associated with changes in muscle mass, but rather some fat mass variables.
Participants on antiretroviral medication exhibited changes relating to abdominal obesity.
It was concluded that antiretroviral therapy contributed greatly to the QoL of the participants and it probably aided in the recovery from wasting for at least one participant
in this study. Measures of the arm can be used in a rural clinical setting to effectively
monitor patients with regard to AIDS related wasting. The new variables IAI and
%IBW:%IAC could be helpful in the monitoring of lipodystrophy and should be
investigated in future research. / AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie is om praktiese metodes te ondersoek om VIGS-verwante
uittering en lipodistrofie te meet in ‘n plattelandse kliniese omgewing (waar hulpbronne
dikwels beperk is) met MIV ge-infekteerde vroue as populasiegroep. Die gebruik van
antropometrie om veranderinge in liggaamssamestelling te meet is beide koste- en
tydeffektief. Verskeie velvoumetings is geneem en twee verskillende vergelykings (die
vergelykings van Pollock et al. (1975) en Durnin en Womersley (1974)) is gebruik om
liggaamsvetinhoud te bereken, met die doel om ‘n belowende metode te vind om
veranderinge in liggaamssamestelling te meet in ‘n kliniese omgewing.
Verskeie antropometriese metings is geneem, sowel as uitgesoekte hematologiese en
lewenskwaliteitmetings (QoL) vir ‘n groep van agt deelnemers wat antiretrovirale
medikasie ontvang het (ART groep) en ses deelnemers wat nie hierdie behandeling ontvang
het nie (TN groep). Nuwe veranderlikes (binnebuikindikator (IAI) en die verhouding van
persentasie van ideale liggaamsmassa tot persentasie van ideale armomtrek
(%IBW:%IAC)) is ondersoek as moontlike aanwysers van lipodistrofie. Drie spesifieke
tydpunte vir die ART groep en twee tydpunte vir die TN groep is gekies uit die verskeie
tydpunte waarby metings geneem is, nl. basislyn (gedefinieer as die dag wat TN deelnemers
in die studie opgeneem is en 0 tot 4 weke voor die begin van behandeling vir die ART
deelnemers), korttermyn (2 tot 12 weke nadat behandeling begin is of na die basislyn
meting) en lang-termyn (binne een en ‘n half jaar nadat behandeling begin is vir die ART
groep).
By die basislyn tydpunt het min van die ART en TN deelnemers se gemete veranderlikes
verskil. Die ART en TN groepe het hoofsaaklik verskil ten opsigte van veranderlikes wat
betrekking het op die arm, veral persentasie van ideale armomtrek (%IAC) en bo-arm vetarea
(UAFA). Hierdie twee veranderlikes was beduidend laer in die ART groep as in die
TN groep.
CD4+ seltelling en lewenskwaliteit tellings het beduidend verbeter vir die ART deelnemers
van die basislyn tot die lang-termyn tydpunt. Hierdie veranderinge is nie samehangend met veranderinge in spiermassa nie, maar eerder met sommige vetmassa veranderlikes.
Deelnemers wat antiretrovirale medikasie ontvang het, het veranderinge getoon wat gedui
het op ‘n verhoogde neerlegging van vet in die buikarea. Ten slotte is bevind dat
antiretrovirale medikasie bygedra het tot die verbeterde lewenskwaliteit van die deelnemers
en dat dit waarskynlik ook die omkeer van uittering van ten minste een deelnemer
aangehelp het. Daar is ook bevind dat armverwante metinge gebruik kan word in die
plattelandse kliniese omgewing om pasiënte suksesvol te monitor ten opsigte van VIGSverwante
uittering. Die nuwe veranderlikes, IAI en %IBW:%IAC kan moontlik gebruik
word om lipodistrofie-verwante veranderings te meet en die gebruik van hierdie
veranderlikes behoort ondersoek te word in verdere navorsing.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/17445 |
| Date | 12 1900 |
| Creators | De Bruto, Petro C. |
| Contributors | Myburgh, K.H., Smith, C., Stellenbosch University. Faculty of Science. Dept. of Physiological Sciences. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 142 leaves : ill. |
| Rights | Stellenbosch University |
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