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Obesity Defining Criteria, and Association with Cardiovascular Disease Risk Factors Among People Living with HIV in
Lucius Chidiebere Imoh1, Temitope Toluse Selowo1, Olumide Bamidele Olaniru1
1Department of Chemical Pathology and Metabolic Medicine, Jos University Teaching Hospital, Plateau State, Nigeria.
Insights
Assessing obesity in people living with HIV (PLHIV) using multiple criteria is crucial for understanding cardiovascular disease (CVD) risk. Central obesity measures, like Waist-Hip-Ratio (WHR), are particularly important for risk assessment in PLHIV.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Obesity is a significant risk factor for non-communicable diseases.
- Understanding obesity in people living with HIV (PLHIV) is critical for managing cardiovascular disease (CVD) risk.
- This study investigates obesity using four criteria and its link to CVD indicators in PLHIV.
Purpose of the Study:
- To evaluate obesity prevalence using Body-Mass-Index (BMI), International Diabetes Federation (IDF), Adult Treatment Panel (ATP), and Waist-Hip-Ratio (WHR) criteria in PLHIV.
- To examine the relationship between different obesity classifications and biochemical/inflammatory markers of CVD in PLHIV.
- To determine the association between obesity and HIV-related parameters.
Main Methods:
- A cross-sectional study of 140 HIV-infected patients in Jos, Nigeria.
- Anthropometric measurements (height, weight, waist, hip circumference) were used to define obesity.
- Fasting plasma glucose, lipid profile, high-sensitivity C-reactive protein (hsCRP), and HIV markers were analyzed.
Main Results:
- Obesity prevalence varied by criteria: BMI (18.6%), IDF (50.7%), ATP (34.3%), WHR (45.7%).
- Obesity by WHR was significantly associated with hypertension and dyslipidemia.
- No significant association was found between obesity criteria and HIV-specific parameters (duration, ARV use, CD4 count).
Conclusions:
- A unified approach to obesity assessment is recommended for PLHIV.
- Parameters of central obesity, such as WHR, should be prioritized for cardiovascular risk assessment in PLHIV.
- Further research into optimal obesity assessment strategies for PLHIV is warranted.
Background:
Obesity is linked to non-communicable conditions. We looked at obesity using four definable criteria and their relationship to biochemical and inflammatory indicators of cardiovascular diseases (CVDs) in people living with HIV (PLHIV).
Methodology:
This cross-sectional study involved 140 randomly selected HIV-infected patients attending HIV clinics at the Jos University Teaching Hospital and Faith Alive Foundation in Jos, Nigeria. Anthropometric measurements such as height, weight, waist circumference, and hip circumference were taken to identify those with obesity. Fasting plasma glucose, lipid profile, High-sensitivity CRP (hsCRP), and HIV-related markers were evaluated.
Result:
The mean (SD) age of the participants was 42.5 (8.8) years, and the majority (71.4%) were females. The prevalence of Obesity based on Body-Mass-Index (BMI), International Diabetes Federation (IDF), Adult Treatment Panel (ATP), and Waist-Hip-Ratio (WHR) criteria were 18.6%, 50.7% 34.3%, and 45.7% respectively. Obesity concordance among the criteria for obesity was highest between IDF and ATP (Kappa= 0.673, p<0.001); and least between BMI vs WHR (Kappa= 0.124, p<0.073). Only 9.3% had obesity by all 4 criteria. BMI was independently associated with hypertension but not glycaemic status nor dyslipidaemia while Obesity by WHR was significantly associated with hypertension and dyslipidaemia, after adjusting for age and sex. There was no significant association between Obesity by all the criteria and HIV-related parameters such as duration of HIV infection, Antiretroviral (ARV) use, and CD4 counts (p>0.05).
Conclusion:
Our study urges a unified assessment of obesity and a more prominent use of parameters of central obesity, for assessing cardiovascular risk in PLHIV.
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