Relation of lean body mass to health-related quality of life in persons with HIV.
OBJECTIVE
To determine the nature and strength of the relation between lean body mass and measures of health-related quality-of-living (HRQL) including physical functioning in men and women with HIV.


METHODS
Cross-sectional analysis using 619 patients with HIV infection from two cities in the northeastern United States.


METHODS
Lean body mass (LBM) was assessed by bioimpedance analysis (BIA). Physical functioning, general health perceptions, energy/fatigue, and number of days spent in bed in the last month were determined by patient self-report.


RESULTS
Data from 450 men and 169 women were analyzed. Mean age was 39 years, 37.6% were nonwhite, and mean CD4 counts were 352 cells/ml. In multivariable models, higher LBM was significantly associated with better physical functioning in men but not in women. In men, a 10-kg increment in LBM was associated with a 3.7 point (95% confidence interval [CI], 0.19-7.2) increment in physical functioning (0-100 scale). In similar analyses, higher LBM was significantly associated with better general health perceptions (10-kg increment in LBM associated with a 4.8 point [95% CI, 1.4-8.1] increment in general health perceptions), and fewer days in bed in the last month (10-kg increment in LBM associated with 0.9 [95% CI, -1.8-0] fewer days in bed). Lean body mass was not independently associated with energy/fatigue.


CONCLUSIONS
In this diverse population of persons with HIV, LBM was significantly related to physical functioning and other measures of HQRL in men, but not in women. In men, the relation was linear but relatively weak. These data have potential implications for assessing the clinical impact of interventions aimed at increasing LBM. Even in men, increases in LBM in the ranges that are currently achievable may produce relatively small improvements in physical functioning and other measures of HRQL.
Wilson
I B
IB
Department of Medicine, New England Medical Center, Tufts University, Boston, Massachusetts 02111, USA. IWilson@Lifespan.org
Roubenoff
R
R
Knox
T A
TA
Spiegelman
D
D
Gorbach
S L
SL
D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000503:physiopathology* / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010465:Perception; D011788:Quality of Life; D012959:Socioeconomic Factors; D014505:Urban Population