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BackgroundBody composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA.MethodsA cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013–2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model.ResultsResults support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor “WI/PI = 1” or without protease inhibitor “WO/PI = 0”); and model five for women (r2 = 0.78, SEE = 0.11, r2PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) (“Yes” for Asian race = 1; “No” = 0).ConclusionsThe proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA.

Background: Dynamic knee extensor muscle strength is a valid measure among healthy older adults but has not been tested in the sarcopenia condition. This study's objective was to test the validity of a one-repetition submaximal strength protocol to measure dynamic knee extension strength in older adults with and without sarcopenia. Methods: Ninety-four physically independent older adults (female: n = 64, 60 to 85 years; male: n = 29, 60 to 85 years) participated in this study in Brazil during 2016-2017. Sarcopenia was classified and isokinetic unilateral knee extension strength was measured at 60°/s. Bilateral dynamic knee extension strength was estimated with an extensor chair using one-repetition submaximal protocol. Validity was determined using Spearman's correlation with isokinetic muscle strength. Results: The frequency of sarcopenia was 11.7%. Sarcopenic individuals presented lower body mass, body mass index and skeletal muscle index. Only chronological age was higher among the sarcopenic individuals. A high correlation was found between isokinetic unilateral knee extension strength and bilateral estimated one-repetition with submaximal protocol (r = 0.74; p < 0.001), when the presence (r = 0.71; p = 0.014) and absence of sarcopenia (r = 0.74; p < 0.001) were considered. The validity of the one-repetition submaximal protocol for bilateral knee extension was confirmed. Conclusions: The estimated measure of bilateral knee extension muscle strength can be used to monitor adaptations promoted by physical exercise for older adults with and without sarcopenia. The validation enable studies that will propose cutoff points to identify sarcopenia with this submaximal protocol. This will enable early diagnosis and better management of sarcopenia, a disease with adverse impacts for older adults.

The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (G RTBFR ) versus, traditional resistance training (G TRT ) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre-and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre-and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (G RTBFR =25.7-57.4%; G TRT= 24.5-52.3%) and skeletal muscle tissue (G RTBFR =8.4%; G TRT =8.3%). There was also a significant change in body fat (p=0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.

Normalizing calf circumference to identify low skeletal muscle mass in older women: a cross-sectional studyNormalización de la circunferencia de la pantorrilla para identificar la masa muscular esquelética baja en las mujeres mayores: un estudio transversal

Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a "lipodystrophy" or "non-lipodystrophy" group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as "original") along with the "Z index" (ZI) values, which were adjusted by the "Phantom Strategy." The cutoff points were proposed when "original" anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA-17 points using the "original" anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using "original" anthropometric measurements and ZI values adjusted by the "Phantom Strategy." Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS.

Compreender a Composição Corporal Funcional (CCF) é fundamental para que os profissionais que trabalham com o corpo e o movimento possam entender as alterações que ocorrem no organismo. De um ponto de vista histórico, a análise da Composição Corporal (CC) era organizada em dois compartimentos, sendo eles Massa Gorda (MG) e Massa Isenta de Gordura (MIG). A CCF associa componentes da CC a vias metabólicas, fisiológicas e bioquímicas, verificando a influência do movimento e proporcionando ao profissional o entendimento básico da CC através dos diferentes modelos de níveis compartimentais e métodos, com vistas a um entendimento mais efetivo por parte deste. Estudos têm evidenciado a relação entre CC desejável e a saúde dos indivíduos. Portanto, o objetivo foi realizar uma breve revisão da literatura sobre CCF e compreender sua influência no organismo, articulada ou não à prática de atividade física (AF). O presente estudo foi realizado a partir de uma revisão narrativa acerca do tema CCF. Como conclusão, a CC é capaz de influenciar o funcionamento do corpo humano e, atualmente, pode ser analisada em cinco níveis. Quanto mais sofisticada a sua quantificação, melhor é o entendimento sobre sua relação com a variação da condição de saúde do organismo (estado nutricional, metabolismo e patologias). O exercício pode beneficiar a CC, mantendo e aumentando os componentes que influenciam positivamente a saúde. 

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