Abstract
ABSTRACT Objective The study aimed to verify the relationship between handgrip strength measurement and classic anthropometric values in HIV positive outpatients. Methods This was a cross-sectional study that enrolled HIV-positive outpatients treated at the Gaffrée and Guinle University Hospital, aged between 20 and 60 years and considered to be well-nourished or moderately malnourished, according to the Global Subjective Analysis. The patients’ bilateral handgrip strength were assessed (Jamar dynamometer), and classic anthropometry variables (weight, height, body mass index, arm muscle area, arm fat area, arm muscle circumference, and triceps skin fold) were measured. The Kolmogorov-Smirnov test, t-test, bivariate correlation and regression analysis were used (SPSS 21® software), with a significance level of 5%. Results A total of 242 patients were assessed. According to the Global Subjective Analysis, 218 (90.1%) patients were classified as well nourished (Global Subjective Analysis-A) and 24 (9.9%) as moderately malnourished (Global Subjective Analysis-B). The average dominant hand handgrip strength with standard deviation was 30.5±9.5kgf and 24.1±6.1kgf for Global Subjective Analysis-A and Global Subjective Analysis-B patients, respectively. Handgrip values were not influenced by age. The handgrip strength showed in both genders a significant correlation with weight, body mass index, and with anthropometric parameters related to lean body mass (arm muscle circumference and arm muscle area), but without correlation with the non-lean mass parameter (arm fat area). The handgrip strength of the dominant hand was a predictor of the following variables associated with lean body mass, i.e., arm muscle circumference and arm muscle area (R2=0.194, t=7.7, p<0.001, and R2=0.192, t=7.6, p<0.001, respectively). However, handgrip strength was not a predictor of arm fat area. Conclusion Measurement of handgrip strength was a useful method for nutritional assessment in outpatients with HIV due to a significant relationship with anthropometric parameters associated with lean body mass.
Highlights
Weight loss is common in the course of Human Immunodeficiency Virus (HIV) infection, occurring since the early stages and may precede immunological impairment [1]
The handgrip strength showed in both genders a significant correlation with weight, body mass index, and with anthropometric parameters related to lean body mass, but without correlation with the non-lean mass parameter
Measurement of handgrip strength was a useful method for nutritional assessment in outpatients with HIV due to a significant relationship with anthropometric parameters associated with lean body mass
Summary
Weight loss is common in the course of Human Immunodeficiency Virus (HIV) infection, occurring since the early stages and may precede immunological impairment [1]. Anthropometric indices related to lean body mass are relevant, since loss of muscle mass is associated with increased mortality, length of hospital stay, depression and reduced quality of life [2]. The measurement of muscle strength is considered a functional and nutritional status indicator in several populations [4]. Among the methods for assessing voluntary muscle strength, the most used and validated in clinical practice is the measurement of Handgrip Strength (HGS), which is able to estimate the overall individual’s strength. It is a simple, low-cost instrument, validated in different populations and performed in outpatients to assess nutritional risk [5]
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