BMI and Risk Factors of Underweight and Obesity in HIV Subjects in Eastern Nigeria

Abstract

Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection, factors associated with weight changes are not completely known. This study evaluated the body mass index (BMI) and its potential risk factors in drug-naïve HIV subjects in Owerri, Eastern Nigeria. Methodology: This was a cross-sectional study of HIV subjects. BMI was determined. Relevant investigations were performed. Potential risk factors of BMI were analyzed at different BMI categories. Association of variables with BMI and the strength of variables to predict BMI, underweight and obesity were determined. Results: The mean BMI of the HIV subjects was 26.2 ± 5.4 kg/m 2. Underweight was present in 24 (6.1%), overweight in 150 (38.4%) and obesity in 84 (21.5%) of the HIV subjects. High spot urine creatinine (SUCr), high 24-hour urine osmolality (24HUOsm), high serum cholesterol and high hemoglobin predicted BMI in HIV subjects. Low 24HUOsm predicted under weight, whereas low 24-hour urine protein (24 HUP) and high 24HUOsm predicted obesity in HIV subjects. Conclusion: The prevalence of underweight was low (6.1%), overweight high (38.4%) and obesity high (21.5%) in HIV subjects. High SUCr, high 24HUOsm, high serum cholesterol and high hemoglobin were predictors of BMI in HIV subjects. Low 24HUOsm was a predictor of underweight, while low 24HUP and high 24HUOsm were predictors of obesity in HIV subjects. Abnormalities of serum lipids, renal function, and anemia were common in HIV subjects who were underweight and in those obese. Underweight HIV subjects should be evaluated at the early stages for dyslipidemia, renal damage and anemia.

Body Mass Index and Associated Factors of Obesity and Underweight in a General Out-patient Population in a Tertiary Hospital in Nigeria

“…The prevalence 10.3% of underweight in subjects attending the general out-patient clinic observed in this study is similar to 6.1% reported by Anyabolu EN [25] in treatment-naïve HIV subjects despite the difference in the HIV status of the subjects in this study. In contrast, this is higher than the 2.5% documented by Chukwuonye et al [16] in Abia State, Nigeria.…”

“…[9] It was, however, lower than the 28.2% and 38.4% reported in two Nigerian studies. [16,25] The first study was community-based, the second HIV clinicbased, while ours was hospital-based: this might be the reason for the difference in the prevalence of overweight compared to that noted in our study.…”

“…Two studies, however, reported an association between 24HUOsm and BMI, though one was in HIV subjects. [21,25] It was noted in this study that serum cholesterol has significant association with BMI, (df=6, p<0.001). It also demonstrated that the prevalence of hypercholesterolemia declined with underweight but increased with obesity.…”

“…This agrees with the reports that demonstrated an association between anemia and weight changes in HIV subjects. [25,26] This demonstrated that anemia was a risk factor of underweight irrespective of the setting in which underweight occurred.…”

“…This contrasts with another study that found no association between serum triglyceride and BMI. [25] On the contrary, one study observed that serum triglyceride increased with obesity. [31] Spot urine protein was a predictor of BMI in this study.…”