Impact of strength training in the lipodystrophy syndrome in people living with HIV

Author(s)

Wlaldemir Roberto dos Santos

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
• Defense date: 2013-07-29

Examining board members

Ana Paula Morais Fernandes; Anderson Marliere Navarro; Pedro Pinheiro Paes Neto

• Advisor: Ana Paula Morais Fernandes

Abstract

Antiretroviral therapy (ART) has changed the AIDS from lethal to chronic disease. However, adverse effects have emerged, like the lipodystrophy syndrome, poor body fat distribution and metabolic changes. It encreases the stigma of this disease and can lead to the abandonment of the use of ART, due the body \"disharmony\" caused by the infection. There is no treatment for lipodystrophy syndrome. Although, the literature indicates that the strength training (ST) helps to control the changes. Thus, the present study aimed to evaluate the impact of strength training in the lipodystrophy syndrome in people living with HIV. There were selected 40 patients from Special Care Unit of Infectious Diseases (UETDI), Clinicas\'s Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo (HCFMRP/USP). Among this, 20 has composed the trained group (practiced ST) and 20 has been for the case group (did not practice ST). All selected patients had practice 36 sessions of ST. Before and after the training period, the patients were submitted to analysis of body composition (circumference and dual-energy X-ray absorptiometry - DXA), biochemical dosages (serum glucose, triglycerides, total cholesterol and fractions) and immunological tests (viral load of HIV and CD4+ T lymphocytes count). The data were analyzed by use of descriptive statistics expressed by mean and standard deviation, with significance predetermined (p <0,05). The results show significant increase of T CD4+ cell count in trained group (p = 0.009) and reduction of viral load (p = 0.010). About metabolic changes, in the trained group was observed reduction of serum glucose, triglycerides, total cholesterol, LDL fraction, and increased HDL fraction, what is positive when compared with the case group. In body composition, DXA has evidenced significantly reduced fat mass in the upper limbs (UL, p = 0.049). It can emphasize the lipoatrophy. However, in the trunk, the fat mass showed a larger decrease in the trained group, what was also seen for the abdominal circumference and the waist, which can evidence the reduced lipohypertrophy. On the other hand, the lean mass increased significantly in the upper limbs (p = 0.000), trunk (p = 0.007) and overall (p = 0.007). This data indicates a better body composition and harmony of the body. Furthermore, the circumference arms (p = 0.024) and thighs (p = 0.012) has been significantly augmented. Bone mineral density (BMD) has increased significantly in the trained group in all measured variables: lumbar spine (p = 0.001), right femoral neck (p = 0.003) and left forearm (p = 0.001). Already the control group did not obtain variations in lumbar spine and had a significant reduction of the right femoral neck (p = 0.020) and left forearm (p = 0.015). Thus, the study has demonstrated that the ST presents an impact on the lipodystrophy syndrome, what is important for favoring the immune system, controlling the metabolic changes, increasing BMD, expanding body harmony and, possibly, improving the quality of life and increasing survival of people living with HIV. (AU)

• FAPESP's process: 11/03136-5 - IMPACT OF RESISTANCE EXERCISE TRAINING IN THE LIPODYSTROPHY SYNDROME IN HIV/AIDS SUBJECTS
• Grantee: Wlaldemir Roberto dos Santos
• Support Opportunities: Scholarships in Brazil - Master