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Abdominal obesity, sarcopenia, and osteoporosis are associated with frailty in men living with and without HIV

Hawkins, Kellie, L.a,b; Zhang, Longc; Ng, Derek, K.c; Althoff, Keri, N.c; Palella, Frank, J., Jr.d; Kingsley, Lawrence, A.e; Jacobson, Lisa, P.c; Margolick, Joseph, B.c; Lake, Jordan, E.f; Brown, Todd, T.g; Erlandson, Kristine, M.a

doi: 10.1097/QAD.0000000000001829

Objective: The relationships between frailty and body composition in older adults with HIV infection are poorly understood. We sought to describe associations between frailty and measures of body composition among adult men with HIV and without HIV.

Design/Methods: Men with and without HIV (age 50–69 years) in the Multicenter AIDS Cohort Study (MACS) Bone Strength Substudy were included if evaluated for frailty (by Fried phenotype) and body composition [BMI, waist circumference, abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, sarcopenia, and osteopenia/osteoporosis]. All participants with HIV infection were on antiretroviral therapy. Multivariate multinomial logistic regression models were used to determine associations of frailty with body composition.

Results: A total of 399 men, including 199 men with HIV and 200 men without HIV, both with median age 60 years, constituted our study population. Frailty prevalence was 16% (men with HIV) vs. 8% (men without HIV). HIV serostatus was associated with a 2.43 times higher odds of frailty (P = 0.01). Higher waist circumference, VAT, sarcopenia, and femoral neck osteoporosis were associated with increased odds of frailty (aOR 4.18, 4.45, 4.15, and 13.6, respectively, and all P < 0.05); BMI and SAT were not. None of these measures presented a differential association with frailty by HIV serostatus (all P > 0.20).

Conclusion: Higher abdominal obesity and sarcopenia were associated with frailty among men with and without HIV. Assessment of these body composition parameters may help detect frailty in the clinical setting.

aUniversity of Colorado, Aurora

bDenver Public Health, Denver, Colorado

cJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

dNorthwestern University Feinberg School of Medicine, Chicago, Illinois

eUniversity of Pittsburgh, Pittsburgh, Pennsylvania

fDepartment of Medicine, McGovern Medical School, Houston, Texas

gJohns Hopkins School of Medicine, Baltimore, Maryland, USA.

Correspondence to Kellie L. Hawkins, 605 Bannock St., Denver, CO 80204, USA. e-mail:

Received 27 November, 2017

Revised 18 February, 2018

Accepted 26 February, 2018

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