A COMPARISON OF ANTHROPOMETRY AND BIOELECTRICAL IMPEDANCE IN THE ESTIMATION OF BODY-COMPOSITION IN HIV-INFECTED INDIVIDUALS

In order to examine the impact of malnutrition on the course and outcome of HIV disease, suitable methods for measuring body composition are needed. The purpose of this research was to assess anthropometry (skin-fold thickness; body mass index) and bioelectrical impedance in HIV-infected patients. Skinfold thickness was measured by two raters at seven sites, body mass index was determined by weight(kg)/[height (m)2], and bioelectrical impedance measurements were used to estimate percent body fat. To classify HIV severity, patients were categorized according to the presence or absence of AIDS, and according to CD4 count (<250; 250-500; >500 cells/mm3). We assessed the following: 1) inter-rater reliability of skinfold thickness measurements; 2) relationship between skinfold thickness and bioelectrical impedance measurements; and 3) relationship between body composition and HIV severity. All 113 patients studied were men, 31% of whom had AIDS. The inter-rater reliability for the sum of all seven skinfold measurements (sum of 7) was excellent (rho >0.97), although the correlation between skinfold measurements (sum of 7) and bioelectrical impedance (percent body fat) was only fair (rho=0.67). Significant differences among CD4 categories were observed in body mass index (p=.006) and bioelectrical impedance (percent body fat) (p=.03), but not in skinfold thickness measurements (p=.06), although a trend was observed. No differences in body composition were observed in patients with and without an AIDS diagnosis. In HIV-infected patients, further evaluation of the relationship between skinfold thickness measurements and bioelectrical impedance is needed. Body 'mass index, a simple anthropometric measure, distinguishes differences in body composition among CD4 categories, and deserves further attention.