博茨瓦纳感染与未感染艾滋病毒成年人中心型肥胖患病率的比较：一项横断面研究。

Comparison of central obesity prevalence among adults living with and without HIV in Botswana: a cross-sectional study.

作者信息

Moshomo Thato, Mawi Moagedi, Williams Christopher G, Molebatsi Kesaobaka, Masupe Tiny, Manyake Kutlo, Lockman Shahin, Molefe-Baikai Onkabetse Julia, Leero Atsile, Jarvis Joseph N, Gaolathe Tendani, Mosepele Mosepele

机构信息

Department of Internal Medicine, University of Botswana Faculty of Medicine, Gaborone, Botswana.

Department of Statistics, University of Botswana, Gaborone, Botswana.

出版信息

BMJ Open. 2025 Apr 21;15(4):e096170. doi: 10.1136/bmjopen-2024-096170.

DOI:10.1136/bmjopen-2024-096170

PMID:40258642

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12015719/

Abstract

OBJECTIVES

The aim was to establish the community prevalence of central obesity in Botswana and assess its association with HIV status.

DESIGN

We performed a one-time central obesity assessment nested within a community-based cluster-randomised controlled HIV treatment and prevention trial (Botswana Combination Prevention Project (BCPP)) conducted in Botswana.

SETTING

The BCPP enrolled consenting adults from a random sample of 20% of households in 30 rural/peri-urban communities.

PARTICIPANTS

A subset of participants from 22 communities was selected for a nested central obesity study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Central obesity was defined as a waist-to-hip ratio (WHR)>0.90 for males and >0.85 for females or as a waist circumference (WC) ≥94 cm for males and ≥80 cm for females. A modified Poisson regression model was used to ascertain the association between central obesity and HIV status. Additionally, the same model was used to estimate the adjusted prevalence ratio (aPR) for central obesity among participants with missing waist and hip measurements by applying inverse probability weighting, and then adjusting for sex and age in the final multivariate models.

RESULTS

Of the 3981 adults, 2039 (51%) completed central obesity assessment (67% female, 29% people living with HIV and median age 35.4 years (IQR 26.4-48.3 years). Central obesity prevalence was 43.5% (95% CI 41.4% to 45.7%) and 50.8% (95% CI 48.6% to 52.9%) as defined by WHR and WC, respectively, and was higher among females than males by WHR (46.9% (95% CI 44.2% to 49.5%) vs 36.7% (95% CI 33.1% to 40.4%)) and WC 68.5% ((95% CI 65.9% to 70.9%) vs 15.1% (95% CI 12.4% to 17.8%)) and increased with age. In fully adjusted models, there was no difference in central obesity by HIV status for both WHR and WC, aPR 0.99 (95% CI 0.90 to 1.09), p value 0.88, and 0.93 (95% CI 0.85 to 1.01), p value 0.06, respectively.

CONCLUSION

Over two-thirds of adult females in Botswana had central obesity; however, living with HIV was not consistently associated with central obesity.

TRIAL REGISTERATION NUMBER

NCT01965470.

摘要

目的

本研究旨在确定博茨瓦纳中心性肥胖的社区患病率，并评估其与艾滋病毒感染状况的关联。

设计

我们在博茨瓦纳开展的一项基于社区的整群随机对照艾滋病毒治疗与预防试验（博茨瓦纳联合预防项目（BCPP））中进行了一次性中心性肥胖评估。

背景

BCPP从30个农村/城郊社区20%的家庭随机样本中招募了同意参与的成年人。

参与者

从22个社区的参与者中选取了一个子集进行嵌套式中心性肥胖研究。

主要和次要结局指标

中心性肥胖定义为男性腰臀比（WHR）>0.90，女性>0.85；或男性腰围（WC）≥94厘米，女性≥80厘米。采用改良泊松回归模型确定中心性肥胖与艾滋病毒感染状况之间的关联。此外，使用相同模型通过应用逆概率加权法估计腰围和臀围测量值缺失的参与者中心性肥胖的调整患病率比（aPR），然后在最终多变量模型中对性别和年龄进行调整。

结果

在3981名成年人中，2039名（51%）完成了中心性肥胖评估（67%为女性，29%为艾滋病毒感染者，中位年龄35.4岁（四分位间距26.4 - 48.3岁））。根据WHR和WC定义，中心性肥胖患病率分别为43.5%（95%置信区间41.4%至45.7%）和50.8%（95%置信区间48.6%至52.9%），按WHR计算女性高于男性（46.9%（95%置信区间44.2%至49.5%）对36.7%（95%置信区间33.1%至40.4%）），按WC计算为68.5%（95%置信区间65.9%至70.9%）对15.1%（95%置信区间12.4%至17.8%），且随年龄增加。在完全调整模型中，无论按WHR还是WC计算，艾滋病毒感染状况与中心性肥胖均无差异，aPR分别为0.99（95%置信区间0.90至1.09），p值0.88，以及0.93（95%置信区间0.85至1.01），p值0.06。