Abdominal adiposity is negatively associated with physical function among people with HIV.

Abstract

Objective: To examine the relationship between body mass index (BMI), abdominal adiposity, handgrip strength and physical function in people with HIV (PWH), and to explore the potential influence of physical activity (PA) and diet on this relationship.

Design: Cross-sectional analyses.

Methods: The PROSPER-HIV Study was conducted at four clinical sites across the United States. Eligible participants were on antiretroviral therapy and had a viral load <200 copies/mL. Measures included: a) handgrip strength; b) physical function, assessed with the Short Physical Performance Battery (SPPB); c) BMI; d) abdominal adiposity, estimated using waist circumference (WC); e) PA levels, measured using accelerometers; and f) diet quality, measured using triple-pass 24-hour recalls. Data were analyzed using quantile regression between covariates and median of the outcomes.

Results: Among PWH (n = 409, 59.0 years old [51.0-65.0], 76.5% male), 71.4% were overweight or obese, 72.4% had high WC, 12.7% had low handgrip strength, and 11.5% had low SPPB. After controlling for age and sex, there was a negative association between SPPB and WC (β=-0.011, p = 0.02). When PA and diet variables were considered in the model, moderate-to-vigorous PA (MVPA) and step count were significant (p < 0.05) and influenced the relationship between WC and SPPB. Although there was a moderate negative correlation between WC and SPPB for the lowest quartiles of MVPA and steps, this correlation weakens as the activity levels increase.

Conclusions: Increased abdominal adiposity is associated with poorer physical function among PWH. Participants with higher MVPA and steps presented higher physical function even in the presence of high WC.