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Gender Differences in Prevalence of Body Habitus Changes and Metabolic Complications in HIV + African American and Latino Individuals from Harlem S. RAGHAVAN*1, A. H. AIDARY2, K. LESTER2, S. SANTOS2, J. WANG3, F. MEDARD1, and W. EL-SADR1.
1Harlem Hosp. Ctr.; 2Columbia Univ.; and 3St. Luke's Hosp. Ctr., New York, NY Introduction: Few data exist on antiretroviral-associated body habitus changes and metabolic complications in African American (AA) and Latino men and women.
Methods: Patients were recruited from the Infectious Diseases Clinics of Harlem Hospital. Self reported change in abdominal & breast girth, peripheral fat wasting, buffalo hump were assessed. Circumferences (arm, thigh, waist & hip), weight, HIV RNA,CD4, random cholesterol (CHOL), triglyceride (TG) & glucose levels were obtained.
Definitions: obesity (BMI >27 kg/m2), >N TG (HTG) & > N CHOL (HCHOL) (>240 mg/dl), hyper-glycemia (>140 mg/dl), > N Waist/Hip ratio (WHR) for Males (M) (>.95), Females (F) (>.85) & > N waist circumference (WC) for M (>1020 mm) & for F (>880), waist/ thigh ratio (WTR).
Results: A Total of 130 patients, 85 % AA, 15% Latino, 39% women, 50% current substance use, 87% hx of substance use, 38 % with RNA levels <400, 18% non PI (protease inhibitor) users. In PI users mean duration on PI is 18 months. In PI users this analysis is restricted to >6 months duration. Mean baseline values for Non PI and PI users: Wt in kg (75, 76), BMI in kg/m2 (26.5, 26.0), CD4 (439, 389), Log RNA (3.2, 3.5), CHOL, Gluc and TG in mg/dl (162, 169), (73, 93), (140, 175), WC in mm (839, 888) and WHR (.88, .92). Prevalence in Non PI & PI using M & F in %: Abdominal obesity (9, 48 P.016), (20, 46, P.137), above normal WHR ( 0, 43, P .034)(75, 68, P.641) & WC (0, 13, P.415)(33, 39, P.592), breast enlargement (0, 14, P .21 5)(27, 39, P .376), obesity (17, 33, P .237)(45, 44, P .617), peripheral fat loss (0, 21, P .081)(18, 18, P.654), HCHOL (0, 8, P .472)(11, 4, P.477), HTG (10, 21, P.386) (0, 13, P. 371) & Hyperglycemia (0, 10, P.374)(0, 0). WTR for Non-PI & PI, M (1.48, 1.74, P <.001) & F (1.61, 1.60, P.882). Only one case of buffalo hump is reported. Regression analysis indicate that the factors associated with WHR, WC and WTR are; gender (P <.001,<.001, .036) and PI duration (P <.001, .014, .063), for WHR and WC only BMI (P.010, <.001) and for WC only race (P.092).
Conclusion: Significantly higher prevalence of abdominal girth, above normal waist/hip ratio, and higher waist/thigh ratio were only found in PI using versus Non-PI using men, and not in PI& Non-PI using women. Hyperglycemia was noted only in PI using men. Prevalence of hyperlipidemia is lower in PI using men than published reports.
Key Words: body habitus changes, metabolic complications, minorities
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