title: Changes in abdominal fat following antiretroviral therapy initiation in HIV-infected individuals correlate with waist circumference and self-reported changes.
abstract: BACKGROUND
  We examined whether waist circumference (WC) and self-reported abdominal size changes can estimate visceral adipose tissue (VAT) changes for those initiating antiretroviral therapy (ART).
  
  
  METHODS
  Prospectively collected data from ACTG A5257 and its metabolic substudy, A5260s, were used for this analysis. ART-naive HIV-infected participants were randomized to one of three contemporary ART regimens. Changes in abdominal CT-measured VAT and total adipose tissue (TAT) and DXA-measured trunk fat were tested for association with WC changes (by Pearson correlation) and categories of self-reported abdominal size changes (by ANOVA) between entry and week 96. Linear models compared WC and self-reported changes.
  
  
  RESULTS
  The study population (n=328) was predominantly male (90%) and White non-Hispanic (44%) with a baseline median age of 36 years and body mass index of 25 kg/m2. At week 96, median WC change was +2.8 cm. Of those reporting at week 96, 53% indicated 'no change/lost', 39% 'gained some/somewhat larger' and 8% 'gained a lot/much larger' as their self-reported changes. Trunk fat, VAT and TAT changes differed across self-reported groups (ANOVA P<0.0001 for all), and the group ordering was as expected. WC changes were strongly correlated with CT and DXA changes (trunk fat: ρ=0.72, p<0.0001; VAT: ρ=0.52, p<0.0001; TAT: ρ=0.62, p<0.0001). While WC changes explained a greater proportion of VAT, TAT and trunk fat variation, self-reported changes remained a significant predictor after controlling for WC (p<0.05).
  
  
  CONCLUSIONS
  WC and self-reported abdominal changes each correlated directly with imaging-derived abdominal fat measures, and can be used as reliable, affordable tools for central adiposity assessment.
authors.affiliation: Present address: Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California, Los Angeles, Los Angeles, CA, USA.|Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Bhagwat
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Ighovwerha
authors.initials: I
authors.lastname: Ofotokun
authors.affiliation: Departments of Pediatrics and Medicine, Case Western University, Cleveland, OH, USA.
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Carlee
authors.initials: C
authors.lastname: Moser
authors.affiliation: Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sugar
authors.affiliation: Department of Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Currier
mesh_terms: D050154:Adiposity / Q000187:drug effects*; D000328:Adult; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D015992:Body Mass Index; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D057566:Self Report; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference; D055815:Young Adult