Anthropometric measures associated with fat mass estimation in children and adolescents with HIV

Abstract

To verify the association between anthropometric indicators and body fat percentage (F %) estimated by dual X-ray absorptiometry (DXA) and air displacement plethysmography (ADP) in children and adolescents diagnosed with HIV. This cross-sectional study was carried out with 62 children and adolescents with HIV (8 to 15 years). F % was estimated by DXA and ADP. Anthropometric indicators were skinfolds (abdominal, triceps, subscapular, calf); perimeter relaxed arm (PRA), waist circumference (WC), perimeter neck (PN); body mass index (BMI); waist-to-height ratio (WHR); conicity index and body adiposity index. Linear regressions were performed with 5% significance level. In boys (R² adj = 0.38 to R² adj = 0.67) and girls (R² adj = 0.41 to R² adj = 0.57), all anthropometric indicators were associated with F% estimated by DXA. For boys, skinfolds were associated with F % estimated by ADP (R² adj = 0.18 to R² adj = 0.35). In girls, skinfolds (R² adj = 0.27 to R² adj = 0.44, BMI (R² adj = 0.31), PRA (R² adj = 0.36) and WC (R² adj = 0.26) were associated to F % by ADP. Abdominal skinfold was the indicator that most explained the variation in F % measured by DXA and ADP in both sexes. Anthropometric indicators are strongly associated with body fat, measured by reference methods, and can assist health professionals in monitoring the health of children and adolescents with HIV.

Nutritional status and its determinants among adolescents with HIV on anti-retroviral treatment in low- and middle-income countries: a systematic review and meta-analysis

“…These 17 primary articles recruited a total of 2873 study participants in LMICs. The majority of articles ( n = 11, 64.7%) were cross-sectional studies [ 19 – 27 ], whilst the remainder ( n = 6, 35.3%) comprised: observational studies ( n = 3) [ 28 – 30 ]; case–control study ( n = 1) [ 31 ]); mixed-method study ( n = 1) [ 32 ], and one clinical trial [ 33 ] (Table 1 ).…”

“…Studies were conducted in seven LMIC countries in South American, Asian and African continents. The majority ( n = 7, 41.2%) took place in upper-middle income countries [ 19 , 21 , 22 , 27 , 28 , 30 , 34 ], followed by low-middle income countries ( n = 5, 29.4%) [ 26 , 29 , 32 , 33 ] and low- income countries (29.4%) [ 20 , 23 – 25 , 35 ] (Table 1 ).…”

“…Regarding factors associated with undernutrition, male sex predisposed to both stunting and wasting, occurring at 1.85 and 2.55 times higher than for their female adolescent counterparts, respectively. This might be a consequence of the generally greater growth spurt and energy requirements of male compared to female adolescents [ 28 , 39 ]. It may also reflect a socio-cultural bias where males are expected to undertake high physical activities to support family subsistence [ 32 ].…”

Metabolic Changes in Pediatric HIV-Positive Patients and Potential Lifestyle Interventional Strategies

“…Through the review, anthropometric measurements were emphasized in order to determine those with increased risk for HIV-associated cardiovascular sequelae [27,28]. The loss of peripheral fat and accumulation of truncal fat is well-reported in HIV and ART patients and can signify an increased risk of cardiovascular events in adulthood [27,28]. These measurements and a series of skin-fold measurements offer a costeffective and quick method to identify those at risk early on for implementation of lifestyle modifications.…”

“…One variant of this is the waist-to-height ratio which helps differentiate between truncal versus total fat and it is also a powerful determinant of body fat in children [31]. In HIV-positive children, the abdominal skinfold (SFab) was the most indicative of fat percentage when compared to the dual x-ray absorptiometry (DXA) fat scan and WC [27,28]. These measurements of visceral adipose tissue (deeper stores of truncal fat) can indicate a child with a higher risk of insulin resistance, dyslipidemia, systemic inflammation, atherosclerosis, and other cardiovascular disease markers [28].…”