Markers of adiposity in HIV/AIDS patients: Agreement between waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index

Abstract

BackgroundWaist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are all independent predictors of cardio-metabolic risk and therefore important in HIV/AIDS patients on antiretroviral therapy at risk of increased visceral adiposity. This study aimed to assess the extent of agreement between these parameters and the body mass index (BMI), as anthropometric parameters and in classifying cardio-metabolic risk in HIV/AIDS patients.MethodsA secondary analysis of data from a cross-sectional study involving 200 HIV/AIDS patients was done. Anthropometric parameters were measured from participants using standard guidelines and central obesity defined according to recommended criteria. Increased cardio-metabolic risk was defined according to the standard cut-off values for all four parameters. Data were analyzed using STATA version 14.1.ResultsThe prevalence of WC-defined central obesity, WHR-defined central obesity and WHtR > 0.50 were 33.5%, 44.5% and 36.5%, respectively. The prevalence of BMI-defined overweight and obesity was 40.5%. After adjusting for gender and HAART status, there was a significant linear association and correlation between WC and BMI (regression equation: WC (cm) = 37.184 + 1.756 BMI (Kg/m2) + 0.825 Male + 1.002 HAART, (p < 0.001, r = 0.65)), and between WHtR and BMI (regression equation: WHtR = 0.223 + 0.011 BMI (Kg/m2)– 0.0153 Male + 0.003 HAART, (p < 0.001, r = 0.65)), but not between WHR and BMI (p = 0.097, r = 0.13). There was no agreement between the WC, WHtR and BMI, and minimal agreement between the WHR and BMI, in identifying patients with an increased cardio-metabolic risk.ConclusionDespite the observed linear association and correlation between these anthropometric parameters, the routine use of WC, WHR and WHtR as better predictors of cardio-metabolic risk should be encouraged in these patients, due to their minimal agreement with BMI in identifying HIV/AIDS patients with increased cardio-metabolic risk. HAART status does not appear to significantly affect the association between these anthropometric parameters.

Anthropometric measures as indicators of the nutritional status of people living with HIV

“…In agreement with our study, the association between BMI and WC (p<0.001) 34 was verified. However, the authors encourage the routine use of indicators such as WC, since they have a better predictive capacity for cardiometabolic risk in patients with HIV infection (k = 0.20, p= 0.001) 34 . Beraldo et al 35 also reinforce the use of WC in the evaluation of PLH, since this parameter evaluates fat deposition in the abdominal region, because abdominal visceral obesity is a more serious cardiovascular risk factor than general obesity, and is usually evaluated by IMC 35 .…”

“…Regarding indirect indicators of central adiposity, other authors, as in our study, found a correlation between BMI and WC (r= 0.65, p<0.001) 34 and when assessing the neck measurement, significant (p<0.0001) correlations were found between NC and BMI in men and women (r= 0.70 and r= 0.81, respectively).…”

“…In the present study, WC identified a significant number of PLH at cardiovascular risk (42.9%), with a higher occurrence of central obesity in females (p= 0.010). Dimala et al 34 evaluated concordance between BMI and independent predictors of cardiometabolic risk (WC, WHR, WHtR) as anthropometric parameters in the classification of cardiometabolic risk in PLH. In agreement with our study, the association between BMI and WC (p<0.001) 34 was verified.…”

“…Dimala et al 34 evaluated concordance between BMI and independent predictors of cardiometabolic risk (WC, WHR, WHtR) as anthropometric parameters in the classification of cardiometabolic risk in PLH. In agreement with our study, the association between BMI and WC (p<0.001) 34 was verified. However, the authors encourage the routine use of indicators such as WC, since they have a better predictive capacity for cardiometabolic risk in patients with HIV infection (k = 0.20, p= 0.001) 34 .…”

Association between Body Fatness and Vitamin D3 Status in a Postmenopausal Population

“…Waist circumference was measured at the midpoint between the lower margin of the least palpable rib and the top of the iliac crest [27]. Hip circumference was measured at the widest portion of the buttocks, with the tape parallel to the floor [28]. Middle arm circumference was measured in the right arm at the midpoint between the tip of the olecranon and the acromion, with the arm hanging loosely [29].…”