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Obesity Affects the Association of Bioelectrical Impedance Phase Angle With Mortality in People Living With HIV
Viola Cogliandro1, Donna Yester, Andrew O Westfall
1Viola Cogliandro, MD, is a Physician, Ospedale Monza San Gerardo, Monza, Italy. Donna Yester, MS, RD, is a Clinical Dietitian, The 1917 Clinic, University of Alabama at Birmingham, Birmingham, Alabama, USA. Andrew Westfall, MS, is a Biostatistician, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. James Raper, DSN, CRNP, JD, is a Professor, School of Medicine and School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Michael Saag, MD, is a Professor, Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. German Henostroza, MD, is an Associate Professor, Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Turner Overton, MD, is a Professor, Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Amanda Willig, PhD, RD, is an Assistant Professor, Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract:
Bioelectrical impedance analysis phase angle (BIA-PA) is a valid indicator of mortality risk in people living with HIV; however, it is not known whether BIA-PA is valid for people living with HIV who are overweight or obese. We assessed whether BIA-PA differentially predicted mortality by body mass index category in participants receiving clinical care at a single site between 2000 and 2012. Change in BIA-PA from the highest versus last available phase angle was assessed using multivariate logistic regression models. Eight hundred ninety participants were included in the final analyses, with 102 deaths recorded during the study period. Decline in BIA-PA was associated with mortality in underweight and normal weight participants but not in overweight or obese participants. Additional investigation is warranted to determine the appropriate clinical BIA-PA equations and parameters to identify overweight and obese patients with increased mortality risk.
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