Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Sagittal Abdominal Diameter as the Best Predictor of Metabolic Syndrome in HIV-Infected Men on Antiretroviral Therapy

Author(s): Zorka Drvendžija*, Biljana Srdić Galić, Miloš Vujanović, Daniela Marić, Nina Brkić Jovanović, Snežana Brkić, Vesna Turkulov and Dalibor Ilić

Volume 22, Issue 2, 2024

Published on: 07 February, 2024

Page: [91 - 99] Pages: 9

DOI: 10.2174/011570162X270929240125055222

Price: $65

conference banner
Abstract

Background: The interaction of human immunodeficiency virus (HIV), host and antiretroviral therapy (ART) causes a range of metabolic disorders that can be characterized as a metabolic syndrome (MetS) that increases the cardiovascular risk. MetS involves central obesity, which can be detected using different anthropometric parameters.

Objective: To assess the abilities of different anthropometric parameters in the prediction of MetS in HIV-infected men on ART.

Method: The study involved 92 male participants (mean age 44.46±10.38 years), divided into two groups: with and without MetS. All subjects underwent biochemical evaluation (triglycerides, HDL-cholesterol, fasting glucose), blood pressure measurement and anthropometric assessment: body mass, body height, body mass index (BMI), body fat mass, body circumferences (chest, upper arm, forearm, waist, hip, proximal and middle thigh and calf), sagittal abdominal diameter (SAD), skinfold thicknesses (subscapular, anterior and posterior upper arm, anterior and lateral forearm, abdominal, supraspinal, thigh and calf), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), sagittal abdominal diameter–to-body height ratio (SADH), body adiposity index (BAI) and conicity index. MetS was specified according to IDF criteria.

Results: Subjects with MetS had statistically significant higher values of all anthropometric parameters except middle thigh circumference, calf skinfold and body height. According to ROC analysis and Binary Logistic Regression, SAD has been shown as the best predictor of MetS with a predictive value of 21.40 cm (AUC:0.91), followed by WHR with a predictive value of 0.93.

Conclusion: Sagittal abdominal diameter is the strongest anthropometric indicator of MetS in HIV-infected patients on ART.

Keywords: Anthropometry, antiretroviral therapy, cardiovascular risk, HIV-infected men, metabolic syndrome, HIV.

« Previous
[1]
Daar ES. Novel approaches to HIV therapy. F1000 Res 2017; 6(F1000 Faculty Rev): 759.
[2]
Maiese EM, Johnson PT, Bancroft T, Goolsby Hunter A, Wu AW. Quality of life of HIV-infected patients who switch antiretroviral medication due to side effects or other reasons. Curr Med Res Opin 2016; 32(12): 2039-46.
[http://dx.doi.org/10.1080/03007995.2016.1227776] [PMID: 27552553]
[3]
Mellgren Å, Eriksson LE, Reinius M, Marrone G, Svedhem V. Longitudinal trends and determinants of patient-reported side effects on ART–a Swedish national registry study. PLoS One 2020; 15(12): e0242710.
[http://dx.doi.org/10.1371/journal.pone.0242710] [PMID: 33362248]
[4]
Worm SW, Lundgren JD. The metabolic syndrome in HIV. Best Pract Res Clin Endocrinol Metab 2011; 25(3): 479-86.
[http://dx.doi.org/10.1016/j.beem.2010.10.018] [PMID: 21663841]
[6]
Worm SW, Friis-Møller N, Bruyand M, et al. High prevalence of the metabolic syndrome in HIV-infected patients: impact of different definitions of the metabolic syndrome. AIDS 2010; 24(3): 427-35.
[http://dx.doi.org/10.1097/QAD.0b013e328334344e] [PMID: 19910787]
[7]
Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A. Prevalence of metabolic syndrome in HIV-infected patients receiving highly active antiretroviral therapy using International Diabetes Foundation and Adult Treatment Panel III criteria: associations with insulin resistance, disturbed body fat compartmentalization, elevated C-reactive protein, and [corrected] hypoadiponectinemia. Diabetes Care 2007; 30(1): 113-9.
[http://dx.doi.org/10.2337/dc06-1075] [PMID: 17192343]
[8]
Bonfanti P, Giannattasio C, Ricci E, et al. HIV and metabolic syndrome: a comparison with the general population. J Acquir Immune Defic Syndr 2007; 45(4): 426-31.
[http://dx.doi.org/10.1097/QAI.0b013e318074ef83] [PMID: 17514013]
[9]
Amirabdollahian F, Haghighatdoost F. Anthropometric indicators of adiposity related to body weight and body shape as cardiometabolic risk predictors in British young adults: superiority of waist-to-height ratio. J Obes 2018; 2018: 1-15.
[http://dx.doi.org/10.1155/2018/8370304] [PMID: 30515323]
[10]
Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018; 20(2): 12.
[http://dx.doi.org/10.1007/s11906-018-0812-z] [PMID: 29480368]
[11]
World Health Organization. Obesity. 2022. Available from: https://www.who.int/health-topics/obesity#tab=tab_1
[12]
The IDF consensus worldwide definition of the metabolic syndrome 2017. 2017. Available from: https://www.idf.org/e-library/consensusstatements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome
[13]
Bosho DD, Dube L, Mega TA, Adare DA, Tesfaye MG, Eshetie TC. Prevalence and predictors of metabolic syndrome among people living with human immunodeficiency virus (PLWHIV). Diabetol Metab Syndr 2018; 10(1): 10.
[http://dx.doi.org/10.1186/s13098-018-0312-y] [PMID: 29483948]
[14]
Jantarapakde J, Phanuphak N, Chaturawit C, et al. Prevalence of metabolic syndrome among antiretroviral-naive and antiretroviral-experienced HIV-1 infected Thai adults. AIDS Patient Care STDS 2014; 28(7): 331-40.
[http://dx.doi.org/10.1089/apc.2013.0294] [PMID: 24914459]
[15]
Bune GT, Yalew AW, Kumie A. The extents of metabolic syndrome among Antiretroviral Therapy exposed and ART naïve adult HIV patients in the Gedeo-zone, Southern-Ethiopia: a comparative cross-sectional study. Arch Public Health 2020; 78(1): 40.
[http://dx.doi.org/10.1186/s13690-020-00420-3] [PMID: 32399212]
[16]
Jain AK, Theengh DP, Yadav P, Nandy P. Assessment of metabolic syndrome in HIV-infected individuals. Indian J Sex Transm Dis AIDS 2017; 38(2): 152-6.
[http://dx.doi.org/10.4103/ijstd.IJSTD_55_16] [PMID: 30148269]
[17]
Idiculla J, D’Souza , Ravindran GD, Singh G, Furruqh S. Diabetes mellitus, insulin resistance, and metabolic syndrome in HIV-positive patients in South India. Int J Gen Med 2011; 4: 73-8.
[http://dx.doi.org/10.2147/IJGM.S15818] [PMID: 21403795]
[18]
Alvarez C, Salazar R, Galindez J, et al. Metabolic syndrome in HIV-infected patients receiving antiretroviral therapy in Latin America. Braz J Infect Dis 2010; 14(3): 256-63.
[http://dx.doi.org/10.1016/S1413-8670(10)70053-2] [PMID: 20835509]
[19]
Bernal E, Masiá M, Padilla S, Martín-Hidalgo A, Gutiérrez F. [Prevalence and characteristics of metabolic syndrome among HIV-infected patients from a Mediterranean cohort]. Med Clin (Barc) 2007; 128(5): 172-5.
[http://dx.doi.org/10.1157/13098391] [PMID: 17298778]
[20]
Beraldo RA, Meliscki GC, Silva BR, et al. Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients. PLoS One 2016; 11(2): e0149905.
[http://dx.doi.org/10.1371/journal.pone.0149905] [PMID: 26919174]
[21]
Dimodi HT, Etame LS, Nguimkeng BS, et al. Prevalence of Metabolic Syndrome in HIV-Infected Cameroonian Patients. World J AIDS 2014; 4(1): 85-92.
[http://dx.doi.org/10.4236/wja.2014.41011]
[22]
Leal JA, Fausto MA, Carneiro M. Anthropometric Risk Factors for Metabolic Syndrome in HIV patients. MedicalExpress (São Paulo) 2016; 3(4): 160-5.
[http://dx.doi.org/10.5935/MedicalExpress.2016.04.05]
[23]
Clumeck N, Pozniak A, Raffi F. European AIDS Clinical Society (EACS) guidelines for the clinical management and treatment of HIV-infected adults. HIV Med 2008; 9(2): 65-71.
[http://dx.doi.org/10.1111/j.1468-1293.2007.00533.x] [PMID: 18257769]
[24]
Alberti KGMM, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet 2005; 366(9491): 1059-62.
[http://dx.doi.org/10.1016/S0140-6736(05)67402-8] [PMID: 16182882]
[25]
Dimala CA, Ngu RC, Kadia BM, Tianyi FL, Choukem SP. Markers of adiposity in HIV/AIDS patients: Agreement between waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index. PLoS One 2018; 13(3): e0194653.
[http://dx.doi.org/10.1371/journal.pone.0194653] [PMID: 29566089]
[26]
Öhrvall M, Berglund L, Vessby B. Sagittal abdominal diameter compared with other anthropometric measurements in relation to cardiovascular risk. Int J Obes 2000; 24(4): 497-501.
[http://dx.doi.org/10.1038/sj.ijo.0801186] [PMID: 10805508]
[27]
Yim JY, Kim D, Lim SH, et al. Sagittal abdominal diameter is a strong anthropometric measure of visceral adipose tissue in the Asian general population. Diabetes Care 2010; 33(12): 2665-70.
[http://dx.doi.org/10.2337/dc10-0606] [PMID: 20843976]
[28]
Risérus U, Ärnlöv J, Brismar K, Zethelius B, Berglund L, Vessby B. Sagittal abdominal diameter is a strong anthropometric marker of insulin resistance and hyperproinsulinemia in obese men. Diabetes Care 2004; 27(8): 2041-6.
[http://dx.doi.org/10.2337/diacare.27.8.2041] [PMID: 15277437]
[29]
Risérus U, de Faire U, Berglund L, Hellénius ML. Sagittal abdominal diameter as a screening tool in clinical research: cutoffs for cardiometabolic risk. J Obes 2010; 2010: 1-7.
[http://dx.doi.org/10.1155/2010/757939] [PMID: 20798888]
[30]
Møller G, Ritz C, Kjølbæk L, et al. Sagittal abdominal diameter and waist circumference appear to be equally good as identifiers of cardiometabolic risk. Nutr Metab Cardiovasc Dis 2021; 31(2): 518-27.
[http://dx.doi.org/10.1016/j.numecd.2020.09.032] [PMID: 33223400]
[31]
Sampaio LR, Simões EJ, Assis AMO, Ramos LR. Validity and reliability of the sagittal abdominal diameter as a predictor of visceral abdominal fat. Arq Bras Endocrinol Metabol 2007; 51(6): 980-6.
[http://dx.doi.org/10.1590/S0004-27302007000600013] [PMID: 17934666]
[32]
Pimentel GD, Moreto F, Takahashi MM, Portero-McLellan KC, Burini RC. Sagital abdominal diameter, but not waist circumference is strongly associated with glycemia, triacilglycerols and HDL-C levels in overweight adults. Nutr Hosp 2011; 26(5): 1125-9.
[PMID: 22072363]
[33]
Kahn HS, Gu Q, Bullard KM, Freedman DS, Ahluwalia N, Ogden CL. Population distribution of the sagittal abdominal diameter (SAD) from a representative sample of US adults: comparison of SAD, waist circumference and body mass index for identifying dysglycemia. PLoS One 2014; 9(10): e108707.
[http://dx.doi.org/10.1371/journal.pone.0108707] [PMID: 25272003]
[34]
Kahn HS, Rissanen H, Bullard KM, Knekt P. The population distribution of the sagittal abdominal diameter ( SAD ) and SAD/height ratio among F innish adults. Clin Obes 2014; 4(6): 333-41.
[http://dx.doi.org/10.1111/cob.12078] [PMID: 25826163]
[35]
Kruger M, Zyl L, Nell T Jnr. Sagittal Abdominal Diameter In HIV Show Strong Correlations In Body Fat Over Two Year HAART in a mixed ancestry HIV Population of South Africa. FASEB J 2015; 29(S1): 25-8.
[http://dx.doi.org/10.1096/fasebj.29.1_supplement.747.14] [PMID: 25318479]
[36]
Tutunchi H, Ebrahimi-Mameghani M, Ostadrahimi A, Asghari-Jafarabadi M. What are the optimal cut-off points of anthropometric indices for prediction of overweight and obesity? Predictive validity of waist circumference, waist-to-hip and waist-to-height ratios. Health Promot Perspect 2020; 10(2): 142-7.
[http://dx.doi.org/10.34172/hpp.2020.23] [PMID: 32296627]
[37]
Hassan MR, Ahmad N, Adam SIM, Nawi AM, Ghazi H. Abdominal obesity indicators: Waist circumference or waist-to-hip ratio in Malaysian adults population. Int J Prev Med 2016; 7(1): 82.
[http://dx.doi.org/10.4103/2008-7802.183654] [PMID: 27330688]
[38]
Baioumi AYAA. Chapter 3 - Comparing Measures of Obesity: Waist Circumference, Waist-Hip, and Waist-Height Ratios. Ronald RW. Nutrition in the Prevention and Treatment of Abdominal Obesity. (2nd ed..). Academic Press 2019; pp. 29-40.
[39]
Azarbad A, Aghnia T, Gharibzadeh A, et al. Cut-off points for anthropometric indices to screen for hypertension among Iranian adults of the Bandare-Kong cohort: a cross-sectional study. BMC Public Health 2022; 22(1): 2064.
[http://dx.doi.org/10.1186/s12889-022-14489-8] [PMID: 36369024]
[40]
Hadigan C, Meigs JB, Wilson PWF, et al. Prediction of coronary heart disease risk in HIV-infected patients with fat redistribution. Clin Infect Dis 2003; 36(7): 909-16.
[http://dx.doi.org/10.1086/368185] [PMID: 12652392]
[41]
Panel on antiretroviral guidelines for adults and adolescents. guidelines for the use of antiretroviral agents in adults and adolescents with HIV 2023. Available from: https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv
[42]
Montessori V, Press N, Harris M, Akagi L, Montaner JS. Adverse effects of antiretroviral therapy for HIV infection. CMAJ 2004; 170(2): 229-38.
[PMID: 14734438]
[43]
Masenyetse LJ, Manda SOM, Mwambi HG. An assessment of adverse drug reactions among HIV positive patients receiving antiretroviral treatment in South Africa. AIDS Res Ther 2015; 12(1): 6.
[http://dx.doi.org/10.1186/s12981-015-0044-0] [PMID: 25745501]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy