A Validation Study of Body Composition by Bioelectrical Impedance Analysis in Human Immunodeficiency Virus (HIV)-Positive and HIV-Negative Hispanic Men and Women
Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA, USA. Journal of the American Dietetic Association
(Impact Factor: 3.92).
03/2008; 108(3):534-8. DOI: 10.1016/j.jada.2007.12.003
Bioelectrical impedance analysis (BIA) is a potentially useful tool for measuring body composition in people with human immunodeficiency virus (HIV). However, it is not clear that equations derived in healthy non-Hispanic whites can be applied to people who are of other races or ethnicities and who are infected with HIV. Body composition measures done by BIA, using the equations of Lukaski, were compared to measures of body composition derived from dual-energy x-ray absorptiometry (DXA) in Hispanic men and women of Caribbean origin (predominantly Puerto Rican) with and without HIV infection. In cross-sectional analyses, body composition was measured by BIA and DXA in four groups of Hispanics: 97 HIV-positive men, 70 HIV-negative men, 38 HIV-positive women, and 14 HIV-negative women. The method of Bland and Altman was used to evaluate the validity of BIA compared to DXA. Compared to DXA, BIA provided accurate measures of fat-free mass in HIV-positive and HIV-negative Hispanic men. Fat-free mass by BIA compared to DXA was overestimated by 2.7 kg (standard deviation=2.5; P<0.0001) in the HIV-positive Hispanic women and by 3.4 kg (standard deviation=2.6; P<0.01) in the HIV-negative women. The magnitude of the bias in fat-free mass was dependent on fat mass in both the men and the women. BIA, using the equations of Lukaski, appears to be useful in this Hispanic population of Caribbean origin with and without HIV, for whom it provided reasonable estimates of body composition. Fat mass affects the accuracy of estimates.
Available from: Grace Munthali
- "Despite the potential benefits of the BIA technique, a limitation is the inability to identify site-specific alterations in body fat, a particular issue in PLHA . Skinfold thickness measurements provide information on regional and whole body composition and hence may be approach to consider visceral fat accumulation and fat loss from limbs, of clinical concern due to the relationship with insulin resistance and other serious metabolic disturbances . "
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ABSTRACT: Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM).
This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status.
This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques.
Pan African Clinical Trial Registry PACTR201108000303396.
Available from: Laura Hornby
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ABSTRACT: Important deteriorations in body composition and strength occur and need to be accurately measured in advanced cancer patients (ACPs). The aim of this study was to establish the relationship between a single-frequency bioimpedance analyzer (BIA) and the dual-energy X-ray absorptiometer (DXA), as well as the Jamar handgrip dynometer and the Biodex handgrip attachment, and to determine the precision of each of these instruments in ACPs. Eighty-one ACPs with non-small-cell lung cancer and gastrointestinal cancer were recruited from the McGill University Health Centre (Montreal, Que.). Consecutive paired measurements, with repositioning between measurements, were obtained for total-body DXA, BIA, Biodex handgrip, and BIA plus Jamar handgrip. The total-body percent coefficient of variation (%CV) for the BIA and DXA were 1.34 and 1.56 for fat mass (FM), respectively, and 0.42 and 0.72 for fat free mass (FFM), respectively. The %CV for the Jamar and Biodex handgrips were 6.3 and 16.7, respectively. Bland-Altman plots were used to characterize the limits of agreement between DXA and BIA for FM (4.60 +/- 7.80 (-3.19 to 12.39) kg) and FFM (-1.87 +/- 7.16 (-9.03 to 5.29) kg). Both DXA and BIA demonstrate good short-term precision in ACPs. However, given its poor accuracy, it remains to be determined if BIA can be used to monitor ACPs for changes in total-body tissue composition as a function of time, whether for observation or response to treatment. Furthermore, because of wide limits of agreement, the DXA and BIA cannot be used interchangeably in research or clinical settings. The Jamar handgrip dynamometer shows more consistency than the Biodex handgrip attachment in ACPs, and should therefore be the preferred measure of changes in strength over time.
Available from: ncbi.nlm.nih.gov
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ABSTRACT: To assess the effects of chronic hepatitis C (HCV) and HIV infection on dyslipidaemia in a Hispanic population at high risk of insulin resistance.
We compared serum lipids and C-reactive protein (CRP) in 257 Hispanic adults including 47 HIV- mono-infected, 43 HCV-mono-infected and 59 HIV/HCV-co-infected individuals as well as 108 healthy controls. We also assessed the effect of HCV on lipid alterations associated with antiretroviral therapy (ART), and the impact of HCV and HIV on the associations among insulin resistance, triglycerides and cholesterol.
HCV infection was associated with lower total and low-density lipoprotein (LDL) cholesterol, but not high-density lipoprotein (HDL) cholesterol or triglycerides compared with healthy controls. HIV infection was associated with higher triglycerides and lower HDL, but not total or LDL cholesterol. HCV mitigated the elevation of triglycerides associated with ART. In healthy Hispanic adults, insulin resistance was significantly correlated with higher triglycerides, CRP and lower HDL. HIV infection nullified the association of insulin resistance with triglycerides and HDL, and the association of triglycerides with LDL. HCV infection nullified the association of insulin resistance with triglycerides, HDL and CRP.
HCV co-infection alters the profile of HIV-associated dyslipidaemia. The clinical significance of these findings for cardiovascular complications in HIV merits further study.
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