Association Between Reduced Daily Protein Intake and Sarcopenic Obesity in Men Living with HIV: A New Screening Tool

TL;DR

This study finds that low daily protein intake is linked to sarcopenic obesity in men with HIV and proposes a new screening tool based on protein intake.

Contribution

A new screening cut-off for sarcopenic obesity in men with HIV based on daily protein intake is proposed.

Findings

Men with HIV and sarcopenic obesity had lower protein intake and higher BMI compared to others.

Protein intake below 0.98 g/kg/day was identified as a screening cut-off for sarcopenic obesity.

The proposed cut-off showed 71% sensitivity and 70% specificity in identifying sarcopenic obesity.

Abstract

Background and Aim: Sarcopenic obesity (SO) is a phenotype characterized by increased body fat combined with reduced muscle mass and strength. SO is prevalent among people living with HIV, especially in men (MLWH); however, the link between this phenotype and diet is still unclear in this population. For this reason, in this study, we aim to examine potential associations between self-reported macronutrient intake and SO in MLWH, and, eventually, to evaluate the diagnostic accuracy of a simple nutritional marker for screening SO. Methods: A total of 216 MLWH were selected from a large cohort who completed a total body composition measurement by dual-energy X-ray absorptiometry (DXA), muscle strength assessment by handgrip test, and nutritional recording by 24 h recall interview. The sample was categorized into SO (n = 45), non-SO (NSO) (n = 33), and non-sarcopenic non-obesity (NSNO) (n = 138). Logistic regression analysis was performed to determine the associations between different macronutrients and SO after adjusting for confounders. Receiver operating characteristic (ROC) curve analysis was used to identify discriminating cut-off points of the determined macronutrient intake to screen for SO. Results: The MLWH with SO while compared to NSO and NSNO, were of an older age and had a higher BMI, but with a lower total caloric and protein intake. However, adjusted logistic regression showed that only protein intake (g/kg/day) (OR = 0.017; 95%CI: 0.003–0.094, p < 0.05) and age (OR = 1.051; 95%CI: 1.011–1.093, p < 0.05) were significantly associated with SO. The age-adjusted ROC analysis identified the 0.98 g/kg/day of protein intake (AUC = 0.8149; p < 0.0001; sensitivity = 71%; specificity = 70%) as a cut-off point to screen for SO in the MLWH. Conclusions: We identified a new cut-off point of daily protein intake able to screen for SO in MLWH, and its use can be implemented in clinical settings.

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