Abdominal adiposity is negatively associated with physical function among people with HIV.

Objective: To examine the relationship between body mass index (BMI), abdominal adiposity, handgrip strength and physical function in people with HIV (PWH), and to explore the potential influence of physical activity and diet on this relationship.

Design: Cross-sectional analyses.

Methods: The PROSPER-HIV Study was conducted at four clinical sites across the United States. Eligible participants were on antiretroviral therapy and had a viral load less than 200 copies/ml. Measures included: handgrip strength; physical function, assessed with the Short Physical Performance Battery (SPPB); BMI; abdominal adiposity, estimated using waist circumference; physical activity levels, measured using accelerometers; and diet quality, measured using triple-pass 24-h recalls. Data were analyzed using quantile regression between covariates and median of the outcomes.

Results: Among PWH [ n  = 409, 59 years old (51.0-65.0), 76.5% male], 71.4% were overweight or obese, 72.4% had high waist circumference, 12.7% had low handgrip strength, and 11.5% had low SPPB. After controlling for age and sex, there was a negative association between SPPB and waist circumference ( β  = -0.011, P  = 0.02). When physical activity and diet variables were considered in the model, moderate-to-vigorous physical activity (MVPA) and step count were significant ( P  < 0.05) and influenced the relationship between waist circumference and SPPB. Although there was a moderate negative correlation between waist circumference and SPPB for the lowest quartiles of MVPA and steps, this correlation weakens as the activity levels increase.

Conclusion: Increased abdominal adiposity is associated with poorer physical function among PWH. Participants with higher MVPA and steps presented higher physical function even in the presence of high waist circumference.