Differences in Muscle Quantity and Quality by HIV Serostatus and Sex

Erlandson, Kristine M.; Langan, Susan; Lake, Jordan E.; Sun, Jing; Sharma, Anjali; Adrian, Stefan; Scherzinger, Ann; Palella, Frank J.; Kingsley, L.; Gange, Stephen J.; Tien, Phyllis C.; Yin, Michael T.; Brown, Thomas R.

doi:10.14283/jfa.2022.11

Cited by 8 publications

(17 citation statements)

References 31 publications

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“…It is likely that participants with obese BMI in the high‐strength group have more muscle mass and/or quality than those in the low‐strength group. In previous reports of PLWH, low‐functioning individuals had less lean mass compared to high‐functioning individuals (Erlandson et al, 2013), and lower muscle quality and quantity were associated with poorer physical function (Erlandson et al, 2022). Together, the present and previously published studies suggest that although total mass is important, improving functional muscle mass could be particularly effective in decreasing frailty risk.…”

Section: Discussionmentioning

confidence: 86%

“…Moreover, we observed differential relationships between body composition and frailty risk based on strength. Future studies should examine how fat‐free mass quantity together with skeletal muscle quality (Erlandson et al, 2022) alters frailty risk differentially based on strength status. Additional strength measures and exercise interventions focused on improving body composition and strength will be beneficial.…”

Section: Discussionmentioning

confidence: 99%

“…We used only a single ASI score for the use of drugs other than alcohol and tobacco.This score includes drugs with different risk profiles, including cannabis, which may differentially modify frailty risk when analyzed separately. Moreover, we observed differential relationships between body composition and frailty risk based on strength.Future studies should examine how fat-free mass quantity together with skeletal muscle quality(Erlandson et al, 2022) alters frailty risk differentially based on strength status. Additional strength measures and exercise interventions focused on improving body composition and strength will be beneficial.…”

mentioning

confidence: 99%

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Alcohol use, physical activity, and muscle strength moderate the relationship between body composition and frailty risk among people living with HIV

Levitt

Simon

Lin

et al. 2022

Alcoholism Clin & Exp Res

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Background Antiretroviral therapy has improved life expectancy among people living with HIV (PLWH). Despite increased longevity, PLWH are at increased risk of age‐related comorbidities, including frailty. We examined the relationship between body composition and frailty among PLWH, and moderation of this relationship by substance use, physical activity (PA), and physical function. Methods Participants (n = 341; 71% male, 48 ± 10 years, body mass index (BMI) = 27.3 ± 7.0 kg/m2) enrolled in the New Orleans Alcohol Use in HIV (NOAH) study underwent measures of body composition, muscle strength, and gait speed. Whole blood phosphatidylethanol (PEth) was measured, and substance use and PA were self‐reported. Frailty risk measures included the 58‐Item Deficit Index (DI58) and the Veterans Aging Cohort Study (VACS) Index 1.0, where higher scores indicate greater frailty risk. Results Multivariable linear regression adjusted for age, sex, and race showed that higher fat‐free mass index (FFMI), body fat (%), waist‐to‐hip ratio, and body mass index (BMI) ≥ 25.0 kg/m2 vs. < 25.0 kg/m2 were significantly (p < 0.05) associated with decreased frailty risk measured by the VACS Index, whereas adjusted analyses showed no association between body composition variables and the DI58 score. Recent alcohol use, muscle strength, and PA, but not lifetime alcohol use or gait speed, significantly moderated associations between body composition variables and frailty risk with medium‐to‐large effect sizes. Subgroup analyses revealed a negative relationship between DI58 and FFMI among people with PEth > 8 ng/ml and negative relationships of VACS Index with FFMI and WHR in people with lower muscle strength. Overweight or obese BMI categories were positively associated with DI58 in people with lower muscle strength or higher PA level but negatively associated in those with higher muscle strength. Conclusions Our findings indicate that body composition has significant modulatory effects on frailty risk in PLWH, where obesity increases the risk of frailty and greater muscle mass may be protective, even in individuals who use alcohol. These results highlight the importance of considering body composition, physical activity, and physical function in assessing frailty risk in PLWH, particularly among individuals who use alcohol. Moreover, they support the implementation of physical activity interventions to ameliorate the risk of frailty in aging PLWH.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Alcohol use, physical activity, and muscle strength moderate the relationship between body composition and frailty risk among people living with HIV

Levitt

Simon

Lin

et al. 2022

Alcoholism Clin & Exp Res

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“…Among women and men with and without HIV, we found that both thigh and trunk muscle density and area were associated with measures of physical function. 14,15,48 Although upper body muscle area would conceivably be more directly associated with upper body measures of strength or function, other studies have found associations between pectoralis muscle area and lower extremity measures, including 30 seconds sit-to-stand 49 and 6-minute walk distance 50 ; thus, some authors have proposed that upper body lean mass may serve as a surrogate for whole-body lean mass. 51 Data on associations with muscle density and function are scarce.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously shown that HIV, in addition to increasing age, may be an important contributor to declines in muscle density and area. 12–16 The health consequences associated with lower muscle density are less well-described, particularly in muscle groups beyond the trunk and thigh, although deposition of ectopic fat in other tissues (eg, liver and pericardium) can have a detrimental impact on cardiometabolic disease risk, driven in part by inflammation. 17…”

Section: Introductionmentioning

confidence: 99%

Associations of Muscle Density and Area With Coronary Artery Plaque and Physical Function

Erlandson

Umbleja

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective: Skeletal muscle quality and mass are important for maintaining physical function during advancing age. We leveraged baseline data from Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) to evaluate whether paraspinal muscle density and muscle area are associated with cardiac or physical function outcomes in people with HIV (PWH). Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in PWH. This cross-sectional analysis focuses on participants who underwent coronary computed tomography at baseline. Lower thoracic paraspinal muscle density (Hounsfield units [HU]) and area (cm2) were assessed on noncontrast computed tomography. Results: Of 805 PWH, 708 had paraspinal muscle measurements. The median age was 51 years and 17% were natal female patients. The median muscle density was 41 HU (male) and 30 HU (female); area 13.2 cm2/m (male) and 9.9 cm2/m (female). In adjusted analyses, greater density (less fat) was associated with a lower prevalence of any coronary artery plaque, coronary artery calcium score >0, and high plaque burden (P = 0.06); area was not associated with plaque measures. Among 139 patients with physical function measures, greater area (but not density) was associated with better performance on a short physical performance battery and grip strength. Conclusions: Among PWH, greater paraspinal muscle density was associated with a lower prevalence of coronary artery disease while greater area was associated with better physical performance. Whether changes in density or area are associated with changes in CAD or physical performance will be evaluated through longitudinal analyses in REPRIEVE.

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