Abstract
IntroductionIn an expanding HAART era, obesity has become a health problem among persons living with HIV (PLWH). Whereas the rising level of obesity has been largely attributed to poor nutrition and exercise habits, differences in biological factors may explain why some individuals gain more weight than others. Thus, our main goal is to prospectively determine in PLWH whether plasma brain-derived neurotrophic factor (BDNF), and hazardous alcohol use (HAU), two overlooked but highly prevalent conditions among PLWH, correlate with an adverse anthropometric profile. Also to test whether these relationships varied in men and womenMethodsThe Platelets mediating Alcohol and HIV Damage Study (PADS) is an ongoing multiethnic study of 400 PLWH receiving regular medical care in South Florida (37% females and 63% males). Semi-annual visits consisted of a medical exam, including anthropometrics to assess both general (body mass index: BMI) and central obesity (waist and hip circumferences). Participants also completed health history questionnaires, and provided a fasting blood sample to obtain BDNF and immune and biochemical assessments.ResultsA sizable proportion of participants met the National Institutes of Health definition of overweight (BMI = 25–29.9 kg/m2; 26%) and obese (BMI ≥ 30 kg/m2; 35%). Women were more likely to be obese than men (OR=4.9, 95% CI=2.9–8.2, p=0.0001). Compared to men, women also exhibited the highest mean plasma BDNF levels (9,959 ± 6,578 vs. 7,470 ± 6,068 pg/ml, p=0.0001). Additional analyses indicated that HAU, particularly heavy drinkers, had the smallest waist and hip circumferences if they were males, but the opposite if they were females. High BDNF levels were positively correlated with BMI. Linear regression analysis revealed that gender, BDNF, and HAU were the best predictors of BMI.ConclusionIn summary, our findings offer novel insights into the relationships between BDNF, and alcohol use among overweight and obese PLWH. Our results also suggest that these relationships may be inherently different by gender.
Highlights
In an expanding highly-active antiretroviral therapy (HAART) era, obesity has become a health problem among persons living with HIV (PLWH)
Additional analyses indicated that hazardous alcohol use (HAU), heavy drinkers, had the smallest waist and hip circumferences if they were males, but the opposite if they were females
High brain-derived neurotrophic factor (BDNF) levels were positively correlated with body mass index (BMI)
Summary
In an expanding HAART era, obesity has become a health problem among persons living with HIV (PLWH). A major milestone in the HIV/AIDS epidemic was the development of highly-active antiretroviral therapy (HAART). With this therapy, scientists and health care providers no longer had to be concerned about AIDS wasting syndrome. One of the current critical issues is that a sizable proportion of persons living with HIV (PLWH) are overweight or obese [1]. This is of concern given that the overall risk of many chronic diseases rises substantially with overweight and obesity [1,2,3,4,5,6]. Mortality rates increase with higher body mass index (BMI), and it has been estimated that at least half of all deaths (53%) among obese individuals could had been prevented with weight reduction [10]
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