瘦体重和总体重的变化与HIV感染患者的身体机能呈弱相关。

Changes in lean body mass and total body weight are weakly associated with physical functioning in patients with HIV infection.

作者信息

Wilson I B, Jacobson D L, Roubenoff R, Spiegelman D, Knox T A, Gorbach S L

机构信息

Division of Clinical Care Research, Tufts University School of Medicine, Boston, Massachusetts, USA.

出版信息

HIV Med. 2002 Oct;3(4):263-70. doi: 10.1046/j.1468-1293.2002.00122.x.

DOI:10.1046/j.1468-1293.2002.00122.x

PMID:12444944

Abstract

CONTEXT

For clinicians managing weight loss in patients with HIV, it would be useful to understand how changes in lean body mass (LBM) effect physical functioning, and whether LBM is more strongly related to physical functioning than total body weight (TBW).

OBJECTIVE

To determine the relationship of changes in LBM and changes in total body weight (TBW) to changes in self-reported physical functioning in men and women with HIV infection.

METHODS

Study design was longitudinal analysis of 1474 patient-intervals (each interval was approximately 6 months long) in 486 persons. Patients were participants in Nutrition for Healthy Living, a cohort study of HIV positive persons in Massachusetts and Rhode Island. The main outcome measure was change in self-reported physical functioning.

RESULTS

Of the 1,474 intervals, 1,165 were contributed by men and 309 by women. The mean CD4 count for the 1,474 intervals was 383 cells/ micro L. In men, 5 kg changes in LBM and TBW were associated with 2.2 (95% confidence interval, 0.9, 3.4, P= 0.001) and 2.6 (95% confidence interval, 1.3, 3.9, P= 0.0002) point changes in physical functioning (on a 100-point scale), respectively, after adjusting for covariates. The relationships of changes in LBM and TBW to changes in physical functioning were linear. In women, there were no significant relationships between changes in LBM or TBW to changes in physical functioning.

CONCLUSIONS

In this longitudinal analysis of relatively healthy persons with HIV infection, changes in LBM and TBW were significantly related to changes in physical functioning in men, but the magnitude of the relationship was small. In women, changes in LBM and TBW were not related to changes in physical functioning. Our data suggest that it is not necessary to measure body composition (lean and fat compartments) to understand the impact of changes in weight on physical functioning - it is sufficient to follow total body weight.

摘要

背景

对于管理感染HIV患者体重减轻情况的临床医生而言，了解瘦体重（LBM）的变化如何影响身体机能，以及LBM与身体机能的关联是否比总体重（TBW）更为紧密，将有所助益。

目的

确定感染HIV的男性和女性中，瘦体重（LBM）变化及总体重（TBW）变化与自我报告的身体机能变化之间的关系。

方法

研究设计为对486人进行的1474个患者间隔期（每个间隔期约6个月）的纵向分析。患者参与了“健康生活营养研究”，这是一项针对马萨诸塞州和罗德岛州HIV阳性者的队列研究。主要结局指标是自我报告的身体机能变化。

结果

在1474个间隔期中，男性贡献了1165个，女性贡献了309个。1474个间隔期的平均CD4细胞计数为383个/微升。在男性中，调整协变量后，LBM和TBW每变化5千克，身体机能分别有2.2（95%置信区间，0.9，3.4，P = 0.001）和2.6（95%置信区间，1.3，3.9，P = 0.0002）分的变化（在100分制量表上）。LBM和TBW变化与身体机能变化之间的关系呈线性。在女性中，LBM或TBW变化与身体机能变化之间无显著关系。