Relative influences of sex, race, environment, and HIV infection on body composition in adults

Background: The factors that control body composition in disease an uncerta in. Objective: We planned to compare the relatitve influences of HIV infection, sex, race, and environment on body composition. Methods: We analyzed results of body composition studies performed by bioel ectrical impedance analysis in 1415 adults from 2 cohorts: white and Africa n American men and women from the United States, and African men and women (279 HIV-infected and 1136 control). The effects of sex and HIV infection o n weight, body cell mass, and fat-free mass were analyzed by using both una djusted and age-, weight-, and height-adjusted data. Results: Control men weighed more and had more body cell mass and fat-free moss than did control women, although control women had more fat. The stron gest correlates with body composition were height and weight, followed by s ex, HIV infection, age, environment. and race. Control men and women weighe d men and had more body cell mass, fat-free mass, and fat than did HIV-infe cted men. However. differences in body composition between HIV-infected and control groups were strongly influenced by sea. Of the differences in weig ht between HIV-infected and uninfected subjects, fat-fret mass accounted fo r 51% in men but only 18% in women, in whom the remainder was. fat. Sex eff ects were similar in African and American groups. Conclusions: Sex has a marked effect on the changes in body composition dur ing HIV infection, with women losing disproportionately more fat than men. Sex-related differences in body composition were narrower in the HIV-infect ed groups. Race and environment had smaller effects than sex and HIV infect ion.