Anthropometric measures of central adiposity are highly concordant with predictors of cardiovascular disease risk in HIV patients
Anthropometric measures of central adiposity are highly concordant with predictors of cardiovascular disease risk in HIV patients
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DOI：
10.1093/ajcn/nqy049
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发表时间：
2018-06-01
影响因子：
7.1
通讯作者：
Foss-Freitas, Maria C.
中科院分区：
文献类型：
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作者：
Beraldo, Rebeca A.;Meliscki, Gabriela C.;Foss-Freitas, Maria C.
背景资料：在接受高效抗逆转录病毒治疗（HAART）的HIV患者中发现的体脂再分布和代谢异常导致动脉粥样硬化，增加心血管疾病风险。目的：我们旨在评估肥胖指标/指数，并提出与接受HAART的HIV患者心血管疾病风险预测因子相关的截止值。设计：为了评估这项横断面研究中的心血管疾病风险，我们进行了心电图检查和负荷心电图检查，测量了踝臂指数和血压动脉高压，进行血脂生化检查，并测量血糖。我们测量了腰围（WC）、臀部、大腿、小腿、颈部、躯干和皮褶厚度（二头肌、三头肌、肩胛下、髂上），进行生物电阻抗分析（BIA），并计算指标[体重指数、腰臀比、腰大腿比、腰小腿比、腰身高比（WHtR）、躯干臂比、经身体脂肪量校正的体重指数，身体肥胖指数、舒适指数、体型指数、脂肪量（百分比）和相位角]。结果：中心性肥胖WC和WHtR指标表现最好，男性WC的曲线下面积（AUC）为0.83（95% CI：0.78，0.89; P < 0.05）;女性WC AUC：0.86（95% CI：0.81，0.91; P < 0.05）;男性WHtR AUC：0.83（95% CI：0.78，0.88; P < 0.05）;女性WHtR AUC：0.85（95% CI：0.80，0.91; P < 0.05）。所有肥胖指标/指数的临界值均与HIV血清阴性人群的临界值不同。WC的临界值为87.75cm（敏感性：82.2%;特异性：75.5%），男性和90.5 cm（敏感性：84.0%;特异性：73.0%）。结论：中心性肥胖的测量/指数与心血管疾病风险的预测因子表现出良好的相关性，本研究中提出的临界值的使用旨在有助于早期识别心血管疾病风险的增加，从而能够进行干预。本试验在巴西临床试验注册中心Registro brasileiro de ensaios clmicos（Rebec）注册为RBR-9 rcxbq。美国临床营养杂志2018;107：883-893。
Background: Body fat redistribution and metabolic abnormalities found in HIV patients receiving highly active antiretroviral therapy (HAART) contribute to an atherogenic profile, increasing cardiovascular disease risk.Objective: We aimed to evaluate adiposity measures/indexes and propose cutoffs associated with predictors of cardiovascular disease risk in HIV patients on HAART.Design: To evaluate cardiovascular disease risk in this crosssectional study, we conducted electrocardiogram exams and stress electrocardiography, measured the ankle brachial index and blood pressure arterial hypertension, conducted lipid biochemical tests, and measured blood glucose. We measured circumferences [waist (WC), hip, thigh, calf, neck, trunk] and skinfold thicknesses (biceps, triceps, subscapular, suprailiac), conducted bioelectrical impedance analysis (BIA), and calculated indexes [body mass index, waist-to-hip ratio, waist-to-thigh ratio, waist-to-calf ratio, waist-to-height ratio (WHtR), trunk-to-arm ratio, body mass index corrected for body fat mass, Body Adiposity Index, comcity index, body shape index, fat mass (percentage), and phase angle]. For evaluating the performance of all adiposity measures/indexes, we used receiver operating characteristic (ROC) curves.Results: Measures of central adiposity WC and WHtR showed the best performances-WC area under the curve (AUC) for men: 0.83 (95% Cl: 0.78, 0.89; P < 0.05); WC AUC for women: 0.86 (95% CI: 0.81, 0.91; P < 0.05); WHtR AUC for men: 0.83 (95% CI: 0.78, 0.88; P < 0.05); and WHtR AUC for women: 0.85 (95% CI: 0.80, 0.91; P < 0.05). All adiposity measures/indexes presented different cutoffs from those proposed for the HIV seronegative population. The cutoffs for WC were 87.75 cm (sensitivity: 82.2%; specificity: 75.5%) for men and 90.5 cm (sensitivity: 84.0%; specificity: 73.0%) for women.Conclusions: The measures/indexes of central adiposity presented excellent associations with predictors of cardiovascular disease risk, and the use of the cutoffs proposed in the present study aims to contribute to the early identification of increasing risk of cardiovascular diseases, enabling interventions. This trial was registered at the Brazilian clinical trials registry Registro brasileiro de ensaios clmicos (Rebec) as RBR-9rcxbq. Am J Clin Nutr 2018;107:883-893.