Abstract
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.>
