Range N S, Malenganisho W, Temu M M, Changalucha J, Magnussen P, Krarup H, Andersen A B, Friis H
National Institute for Medical Research, Muhimbili Medical Research Centre, P.O. Box 3436, Dar es Salaam, Tanzania.
Ann Trop Med Parasitol. 2010 Jan;104(1):81-90. doi: 10.1179/136485910X12607012373830.
To estimate the weight deficit and body composition of cases of pulmonary TB (PTB), and assess the roles of HIV and the acute-phase response, a cross-sectional study was carried out in Tanzania. Weight, body mass index (BMI), arm muscle area (AMA), arm fat area (AFA) and the serum concentration of the acute-phase protein alpha(1)-antichymotrypsin (serum ACT) were evaluated for each of 532 cases of PTB and 150 'non-TB' controls. On average, the female cases of PTB not only weighed 7.8 kg less but also had BMI that were 3.1-kg/m(2) lower, AMA that were 14.8-cm(2) lower, and AFA that were 7.6-cm(2) lower than those seen in the female subjects without TB. Similarly, on average, the male cases of PTB weighed 7.1 kg less and had BMI that were 2.5-kg/m(2) lower, AMA that were 18.8-cm(2) lower and AFA that were 1.6-cm(2) lower than those seen in the male subjects without TB. Although HIV infection was associated with a 1.7-kg lower weight and a 0.6-kg/m(2) lower BMI (with deficits in both AMA and AFA) among males, it was not associated with any such deficits among the female subjects. Elevated serum ACT was found to be a negative predictor of BMI, AMA and AFA, partially explaining the effects of the PTB but not those of the HIV. There is need for a better understanding of the determinants and effects of loss of fat and lean body mass in HIV-positive tuberculosis.
为了评估肺结核（PTB）患者的体重不足情况和身体组成，并评估HIV及急性期反应的作用，在坦桑尼亚开展了一项横断面研究。对532例PTB患者和150名“非结核”对照者分别评估了体重、体重指数（BMI）、上臂肌肉面积（AMA）、上臂脂肪面积（AFA）以及急性期蛋白α1-抗糜蛋白酶的血清浓度（血清ACT）。平均而言，PTB女性患者的体重不仅比未患结核的女性轻7.8千克，而且BMI低3.1kg/m²，AMA低14.8cm²，AFA低7.6cm²。同样，平均而言，PTB男性患者的体重比未患结核的男性轻7.1千克，BMI低2.5kg/m²，AMA低18.8cm²，AFA低1.6cm²。虽然HIV感染与男性体重降低1.7千克和BMI降低0.6kg/m²（AMA和AFA均有减少）有关，但在女性受试者中未发现此类体重减少情况。血清ACT升高是BMI、AMA和AFA的负向预测指标，这部分解释了PTB的影响，但不能解释HIV的影响。有必要更好地了解HIV阳性结核病患者脂肪和瘦体重丢失的决定因素及影响。
