Measurement of body composition in postpartum South African women living with and without HIV infection.

Background: While several methodologies are available to measure adiposity, few have been validated in sub-Saharan African (SSA) and none in postpartum African women living with HIV (WLHIV). We compared bioelectrical impendence analysis (BIA) and air displacement plethysmography (ADP) against dual x -ray absorptiometry (DXA) in South African women and examined differences by HIV and body mass index (BMI) status.
Methods: Lin's concordance correlation coefficient (CCC) test was used to examine fat mass (FM), fat free mass (FFM), and total body fat percent (%BF) difference between BIA vs. DXA, and ADP vs. DXA in women living with HIV ( n = 57) and without HIV ( n = 25). The Bland Altman test was used to assess mean differences and the direction of bias.
Results: The median age was 31 years (IQR, 26-35) and months postpartum were 11 (IQR, 7-16), 44% of the women had obesity. Lin's CCC for BIA and ADP vs. DXA were both 0.80 for %BF and 0.97 for FM, and 0.86 and 0.80 for FFM, respectively. Mean differences (DXA-BIA and ADP estimates) were 0.22 ± 4.54% ( p = 0.54) and 3.35 ± 3.27% ( p < 0.01) for %BF, -0.82 ± 3.56 kg ( p = 0.06) and 1.43 ± 2.68 kg ( p = 0.01) for FM, -1.38 ± 3.61 kg (p = 0.01) and - 3.34 ± 2.37 kg ( p < 0.01) for FFM, respectively. BIA overestimated %BF in WLHIV and underestimated it in women with obesity.
Conclusion: Body composition measurements using BIA and ADP correlated well with DXA, thereby providing alternative, safe tools for measuring postpartum FM and FFM in SSA women, including WLHIV.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2024 Madlala, Myer, Geffen, Meyer, Mendham, Goedecke, Bengtson, Jao and Dugas.)