Longitudinal Associations of Body Composition with Cardiometabolic Markers in Men Living with HIV: A Prospective Study

Abstract Objective To examine longitudinal associations between body composition and cardiometabolic markers in men living with human immunodeficiency virus (HIV) receiving stable antiretroviral therapy. Methods This prospective observational study included 143 men assessed at baseline and at 6, 12, and 18 months. Body composition was estimated using bioelectrical impedance analysis. Adjusted linear mixed-effects models separated within-patient changes from between-patient differences. Associations were evaluated after false discovery rate correction. An exploratory analysis compared body-fat percentage with body mass index (BMI) for lipid outcomes. Results Among 143 men, within-patient decreases in body-fat percentage were associated with lower total, LDL, and calculated VLDL cholesterol, triglycerides, fasting glucose, uric acid, and systolic and diastolic blood pressure after false discovery rate correction. Decreases in visceral fat index were associated with the same outcomes except uric acid. Increases in estimated absolute skeletal-muscle mass, conditional on concurrent weight change, were associated with lower total cholesterol, uric acid, and diastolic blood pressure. In exploratory analyses, body-fat percentage retained associations with total, LDL, and calculated VLDL cholesterol and triglycerides after accounting for concurrent BMI change; however, superior cross-validated predictive performance compared with BMI was not established. Conclusion Within-patient reductions in adiposity were associated with favourable changes in cardiometabolic markers among men living with HIV receiving stable ART. The clinical utility of bioimpedance-derived body-composition measures requires further validation.