Background: To describe prevalence, incidence and risk factors for sarcopenic obesity (SO) phenotypes in people living with HIV (PWH) and their association with subclinical cardiovascular disease (CVD). Methods: Observational, longitudinal study of PWH. A minimum of one criterion was necessary to diagnose sarcopenia: (i) weak hand grip (HG), (ii) low appendicular skeletal muscle index (ASMI), (iii) short physical performance battery (SPPB <11). Obesity was defined as (i) body mass index (BMI) ≥30 kg/m2 or (ii) visceral adipose tissue (VAT) ≥160 cm2. These variables combined generated five SO phenotypes: (i) severe SO: low HG+ low ASMI + low SPPB + high BMI; (ii) SO1: weak HG + high VAT; (iii) SO2: weak HG + high BMI; (iv) SO3: low ASMI + high VAT; (v) SO4: low ASMI + high BMI. Subclinical CVD was defined as carotid intima media thickness (IMT) ≥1 mm, presence of carotid plaque, or CAC score >10. Results: Among 2379 PWH 72% men, median age was 52 years, median HIV vintage 21 years, and median BMI 24 kg/m2. Two PWH had severe SO. The prevalence of SO1-SO4 was 19.7%, 3.6%, 20.8% and 0.8% respectively. Incidence of SO1-SO4 was 6.90, 1.2, 5.6 and 0.29 x 100 persons-year, respectively. SO1 was associated with risk of IMT ≥ 1, and SO3 with risk of CAC score >10. Conclusions: There was a large variability in incidence and prevalence of SO phenotypes. The presence of SO may have important implications for cardiovascular prevention and cardiac rehabilitation of PWH who suffered an event.
Sarcopenic Obesity Phenotypes in Patients With HIV: Implications for Cardiovascular Prevention and Rehabilitation
Calza, Stefano;Renzetti, Stefano;
2023-01-01
Abstract
Background: To describe prevalence, incidence and risk factors for sarcopenic obesity (SO) phenotypes in people living with HIV (PWH) and their association with subclinical cardiovascular disease (CVD). Methods: Observational, longitudinal study of PWH. A minimum of one criterion was necessary to diagnose sarcopenia: (i) weak hand grip (HG), (ii) low appendicular skeletal muscle index (ASMI), (iii) short physical performance battery (SPPB <11). Obesity was defined as (i) body mass index (BMI) ≥30 kg/m2 or (ii) visceral adipose tissue (VAT) ≥160 cm2. These variables combined generated five SO phenotypes: (i) severe SO: low HG+ low ASMI + low SPPB + high BMI; (ii) SO1: weak HG + high VAT; (iii) SO2: weak HG + high BMI; (iv) SO3: low ASMI + high VAT; (v) SO4: low ASMI + high BMI. Subclinical CVD was defined as carotid intima media thickness (IMT) ≥1 mm, presence of carotid plaque, or CAC score >10. Results: Among 2379 PWH 72% men, median age was 52 years, median HIV vintage 21 years, and median BMI 24 kg/m2. Two PWH had severe SO. The prevalence of SO1-SO4 was 19.7%, 3.6%, 20.8% and 0.8% respectively. Incidence of SO1-SO4 was 6.90, 1.2, 5.6 and 0.29 x 100 persons-year, respectively. SO1 was associated with risk of IMT ≥ 1, and SO3 with risk of CAC score >10. Conclusions: There was a large variability in incidence and prevalence of SO phenotypes. The presence of SO may have important implications for cardiovascular prevention and cardiac rehabilitation of PWH who suffered an event.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
