Poster Topical Area: Nutritional Epidemiology
Location: Hall D
Poster Board Number: 795
Background: During the pre-antiretroviral therapy (ART) era, higher body mass index (BMI) was shown to have a beneficial effect on HIV disease progression. However, results from studies on the relationship between BMI and CD4 cell recovery in adults on ART are inconsistent. In the general population, the risk for cardiovascular disease increases with higher BMI. The objective of this study was to evaluate the relationship between body composition, CD4 cell count, a measure of HIV disease progression, and metabolic syndrome (MS) in HIV+ adults in the MASH cohort in Miami, Florida.
Methods: A cross-sectional analysis of data from an observational longitudinal study was conducted in 251 HIV+ adults on ART. Anthropometrics and bioimpedance were obtained. Blood was drawn for lipid panel and CD4 count was obtained from medical records. MS was defined as having ≥3 of the following factors: waist circumference >102 cm in men or 89 cm in women, triglycerides ≥150 mg/dL, high density lipoprotein cholesterol ≤40 mg/dL in men or ≤50 mg/dL in women; blood pressure ≥130/85 mmHg; and serum glucose ≥100 mg/dL. Wilcoxon, chi-square and logistic regression analyses were completed.
Results: The median age was 53 years (IQR=49-58) and 59% were male. Those with a BMI ≥25 kg/m2 compared to those will a lower BMI had higher median levels of CD4 cell count [614 (IQR=365-882) vs. 411 cells/µL (IQR=314-706), P=0.002]. This relationship remained significant up to a BMI cut-off of 37 kg/m2 (P=0.05). A body fat mass of >25% for men or 31% for women was also associated with higher median CD4 cell counts [640 (IQR=356-869) vs. 532 cells/µL (IQR=310-724), P=0.016]. In a linear regression model adjusting for age and gender, BMI was associated with CD4 cell count (β=0.16, SE=0.07, P=0.026). BMI >30 kg/m2 was associated with a 4.9 greater odds of having MS than lower BMI (OR=4.87, 95% CI: 2.55, 9.31, P
Conclusions: We confirmed a direct relationship between increased BMI, body fat mass and CD4 cell count in an HIV infected population on ART. However, we showed a direct relationship between BMI with MS, which raises the risk for cardiovascular disease and other conditions such as diabetes and stroke. Additional research is needed to observe the interaction of HIV and obesity overtime on morbidity and mortality.
Florida International University