Friis Henrik, Gomo Exnevia, Nyazema Norman, Ndhlovu Patricia, Kaestel Pernille, Krarup Henrik, Michaelsen Kim F
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
J Nutr. 2002 Dec;132(12):3747-53. doi: 10.1093/jn/132.12.3747.
Human immunodeficiency virus (HIV) infection affects body composition, but their relationship has not been studied in pregnant women. We conducted a cross-sectional study among 1669 women receiving antenatal care between 22 and 35 wk of gestation in Harare, Zimbabwe. The role of HIV-1 status and viral load, malaria and elevated serum alpha(1)-antichymotrypsin (ACT, an acute phase protein) in weight, body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TSF), and arm muscle (AMA) and fat (AFA) area were assessed using multiple linear regression analysis. The mean (range) age was 24.4 (14-45) y and gestational age 29 (22-35) wk. HIV infection was present in 31.5% of the women, malaria parasitemia in 0.4% and 11.4% had serum ACT >0.4 g/L. There was no difference in any anthropometric variable between HIV-infected and uninfected women. However, women with viral loads (genome equivalents/mL) between 4 and 5 and >5 log(10) had 1.1 [95% confidence interval (CI): -0.3, 2.3] and 2.5 (95% CI: 0.1, 5.1) kg lower weights compared with uninfected women; this was explained by losses of both AFA and AMA. Malaria parasitemia was associated with 6 cm(2) (95% CI: 0.4; 11.8) or 25% lower AMA. Elevated serum ACT was a negative predictor of all anthropometric variables, i.e., levels between 0.3 and 0.4, 0.4 and 0.5 and >0.5 g/L were associated with 1, 2 and 6 kg lower mean body weights, respectively. Despite the limitations of a cross-sectional design, we conclude that arm fat and muscle areas, reflecting body fat and lean body mass, seem to be unaffected in the majority of HIV-infected pregnant women, but decline with increasing viral loads. The effects of viral load are not explained by elevated serum ACT, which is a strong independent predictor of all anthropometric variables.
人类免疫缺陷病毒（HIV）感染会影响身体组成，但它们之间的关系在孕妇中尚未得到研究。我们在津巴布韦哈拉雷对1669名妊娠22至35周接受产前护理的妇女进行了一项横断面研究。使用多元线性回归分析评估了HIV-1感染状态和病毒载量、疟疾以及血清α(1)-抗糜蛋白酶（ACT，一种急性期蛋白）升高对体重、体重指数（BMI）、上臂围（AC）、三头肌皮褶厚度（TSF）以及上臂肌肉（AMA）和脂肪（AFA）面积的作用。平均（范围）年龄为24.4（14 - 45）岁，孕周为29（22 - 35）周。31.5%的妇女感染了HIV，0.4%的妇女有疟疾寄生虫血症，11.4%的妇女血清ACT>0.4 g/L。HIV感染妇女和未感染妇女在任何人体测量变量上均无差异。然而，病毒载量（基因组当量/毫升）在4至5 log(10)和>5 log(10)之间的妇女与未感染妇女相比，体重分别低1.1 [95%置信区间（CI）：-0.3，2.3]和2.5（95% CI：0.1，5.1）千克；这可以通过AFA和AMA的减少来解释。疟疾寄生虫血症与AMA减少6平方厘米（95% CI：0.4；11.8）或25%相关。血清ACT升高是所有人体测量变量的负预测因子，即水平在0.3至0.4、0.4至0.5和>0.5 g/L之间分别与平均体重降低1、2和6千克相关。尽管横断面设计存在局限性，但我们得出结论，反映身体脂肪和瘦体重的上臂脂肪和肌肉面积在大多数感染HIV的孕妇中似乎未受影响，但会随着病毒载量增加而下降。病毒载量的影响不能用血清ACT升高来解释，血清ACT升高是所有人体测量变量的一个强有力的独立预测因子。
