RÉSUMÉ
Background: The indices of obesity (measured by Body Mass Index, waist circumference, and weight-to-height ratio) have been observed to be strongly associated with cardiovascular risk. Body mass index (BMI) is a measure of general obesity while waist circumference (WC) and waist-to-height ratio (WHtR) are used to measure central obesity, with the latter suggested to be the indicator for the prediction of cardiovascular risks. This study aimed to determine the advantage of WHtR for cardiovascular risk over the use of other indices of obesity.Methods: The study was a cross-sectional descriptive design carried out among 441 participants at the Metabolic Research Laboratory LTH Ogbomoso excluding pregnant or breastfeeding mothers, thyroid disease, those diagnosed with hypertension, diabetes, or hyperlipidemia, those on blood-pressure, blood-glucose or lipid-lowering medications; those on weight-control medications or supplements. A structured self-administer questionnaire was distributed to obtain socio-demographic data of participants. Physical examination was done with anthropometry measurements. Fasting blood samples were obtained for blood glucose and lipid profiles. Data analysis was done using SPSS version 21.Results: The study included 441 subjects with male to female ratio of 1:1.47 mean age of 37.92�.80 and 34.72�.16 respectively. Blood pressure, pulse rate, height and other obesity indices except waist circumference were all statistically significantly higher in the males than in the females p <0.05. There was a statistically significant difference in the BMI between the sexes for all categories with the majority of female subjects having abnormal BMI and waist circumference. There was a statistically significant relationship between all the obesity indices (BMI, WHtR & WC) and the cardiovascular risk factors excluding TG and HDLC P <0.05.Conclusion: It was observed that all indices of obesity measured in this study were sensitive and significant in determining cardiovascular risk. It could be concluded that WHtR does not have a special or greater advantage over BMI and WC as all indices showed a significant association with cardiovascular risks. Also, the level of statistical significance suggested that either of these obesity indices could be used independently as a predictor of cardiovascular risk.
RÉSUMÉ
Background: antiretroviral therapy has changed the outlook of AIDS. However, identifying factors that will strengthen its maintenance is vital to treatment success. Advocacy is growing on the need for close attention to immunological progress, prevention of excessive body weight gain and associated immunological and metabolicconsequences for better long-term outcomes among PLWHIV in Africa. Aims: To study prevalence, determinants of adherence, and the existing relationship between body weight and CD4 count among adherents and non-adherent patients on HAART. Methodology: A cross-sectional design for sampling of 270 patients on HAARTS was made and pharmacy based adherence was calculated. Patients were categorized into weight groups according to WHO guideline and CD4 count was determined at baseline, third and sixth months. Result: Calculated overall pharmacy adherence was 62.6% over six months. Disclosure to a close family member (p=0.013) and living outside the city of care (p=0.025) significantly predict adherence. Pretreatment overweight (BMI-25- 29.9) and obesity (BMI>30.0) were temporary beneficial to CD4 constitution at baseline (p=0.004), while overweight (p=0.041) and obesity (p=0.150) were associated with lower CD4count repopulation at six months post- HAART compared to normal body weight (BMI-18.5– 24.9), p˂0.001. Adherent PLWHIV participants had higher body weight increasing effect, but demonstrated lower CD4 lymphocyte count increasing effect compared to the nonadherent at six months post-HAART, (p<0.001). Conclusion: Normal body weight and maintenance during HAART seems beneficial for immune reconstitution at six months post- HAART. While emphasizing good adherence to HAART, it becomes necessary for programme implementers to watch against excessive body weight gain and attendants adverse immunological consequences.