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-naïve 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 BMI 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.