title: A lower body mass index is associated with cardiomyopathy in people with HIV infection: evidence from a case comparison study.
abstract: The cause of cardiomyopathy in patients infected with the human immunodeficiency virus (HIV) remains largely unknown, although a number of predisposing factors have been identified. Malnutrition has been postulated to be a contributory factor, but the association of anthropometric measures of nutritional status with HIV-associated cardiomyopathy has not been established.
  
  
  METHODS
  We investigated the association between anthropometric measures of nutritional status and cardiomyopathy in HIV-positive individuals in a cross-sectional case comparison study.
  
  
  RESULTS
  Seventeen cases of HIV-associated cardiomyopathy and a comparison group of 18 HIV-positive individuals without cardiomyopathy were studied. There was no significant difference between the two groups in age, gender, CD4 cell count, HIV RNA viral load or World Health Organization (WHO) clinical stage of HIV disease. Patients with HIV-associated cardiomyopathy had evidence of undernutrition compared with HIV-infected people without cardiomyopathy, as evidenced by a significantly lower body mass index (BMI) (20.9 kg/m2 v. 27.0 kg/m2, p = 0.02), mid-upper arm circumference (26.2 cm v. 27.3 cm, p = 0.02), and bone-free arm muscle area (26.7 cm2 v. 32.8 cm2, p = 0.02). However, in a multivariate stepwise logistic regression model, a lower BMI was the only independent anthropometric risk factor for cardiomyopathy (odds ratio 0.76, 95% confidence interval 0.64 - 0.97, p = 0.02).
  
  
  CONCLUSIONS
  A lower BMI is associated with cardiomyopathy in people who are living with HIV.
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town.
authors.forename: C E
authors.initials: CE
authors.lastname: Lemmer
authors.forename: M
authors.initials: M
authors.lastname: Badri
authors.forename: M
authors.initials: M
authors.lastname: Visser
authors.forename: B M
authors.initials: BM
authors.lastname: Mayosi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D009202:Cardiomyopathies / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D006678:HIV / Q000235:genetics*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology
chemical_list: D004279:DNA, Viral