围生期感染 HIV 且暴露于 HIV 但未感染的儿童的体脂分布：来自儿科 HIV/AIDS 队列研究的结果。
Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study.
机构信息
Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA, USA.
出版信息
Am J Clin Nutr. 2011 Dec;94(6):1485-95. doi: 10.3945/ajcn.111.020271. Epub 2011 Nov 2.
BACKGROUND
Associations between abnormal body fat distribution and clinical variables are poorly understood in pediatric HIV disease.
OBJECTIVE
Our objective was to compare total body fat and its distribution in perinatally HIV-infected and HIV-exposed but uninfected (HEU) children and to evaluate associations with clinical variables.
DESIGN
In a cross-sectional analysis, children aged 7-16 y in the Pediatric HIV/AIDS Cohort Study underwent regionalized measurements of body fat via anthropometric methods and dual-energy X-ray absorptiometry. Multiple linear regression was used to evaluate body fat by HIV, with adjustment for age, Tanner stage, race, sex, and correlates of body fat in HIV-infected children. Percentage total body fat was compared with NHANES data.
RESULTS
Males accounted for 47% of the 369 HIV-infected and 51% of the 176 HEU children. Compared with HEU children, HIV-infected children were older, were more frequently non-Hispanic black, more frequently had Tanner stage ≥3, and had lower mean height (-0.32 compared with 0.29), weight (0.13 compared with 0.70), and BMI (0.33 compared with 0.63) z scores. On average, HIV-infected children had a 5% lower percentage total body fat (TotF), a 2.8% lower percentage extremity fat (EF), a 1.4% higher percentage trunk fat (TF), and a 10% higher trunk-to-extremity fat ratio (TEFR) than did the HEU children and a lower TotF compared with NHANES data. Stavudine use was associated with lower EF and higher TF and TEFR. Non-nucleotide reverse transcriptase inhibitor use was associated with higher TotF and EF and lower TEFR.
CONCLUSION
Although BMI and total body fat were significantly lower in the HIV-infected children than in the HEU children, body fat distribution in the HIV-infected children followed a pattern associated with cardiovascular disease risk and possibly related to specific antiretroviral drugs.
背景
在儿科 HIV 疾病中，异常体脂分布与临床变量之间的关联尚不清楚。
目的
我们的目的是比较围生期感染 HIV 和未感染 HIV 的暴露但未感染（HEU）儿童的全身脂肪及其分布，并评估与临床变量的关系。
设计
在一项横断面分析中，儿科 HIV/AIDS 队列研究中的 7-16 岁儿童通过人体测量方法和双能 X 射线吸收法进行区域性身体脂肪测量。使用多元线性回归评估 HIV 对体脂的影响，调整年龄、Tanner 分期、种族、性别以及 HIV 感染儿童体脂相关因素。将总身体脂肪百分比与 NHANES 数据进行比较。
结果
男性占 369 例 HIV 感染儿童的 47%，占 176 例 HEU 儿童的 51%。与 HEU 儿童相比，HIV 感染儿童年龄较大，非西班牙裔黑人较多，Tanner 分期≥3 的比例较高，平均身高（-0.32 比 0.29）、体重（0.13 比 0.70）和 BMI（0.33 比 0.63）z 评分较低。平均而言，HIV 感染儿童的总身体脂肪百分比（TotF）低 5%，四肢脂肪百分比（EF）低 2.8%，躯干脂肪百分比（TF）高 1.4%，躯干与四肢脂肪比例（TEFR）高 10%，与 HEU 儿童相比，TotF 也低于 NHANES 数据。使用司他夫定与 EF 降低和 TF 升高以及 TEFR 升高相关。使用非核苷酸逆转录酶抑制剂与 TotF 和 EF 升高以及 TEFR 降低相关。
结论
尽管 HIV 感染儿童的 BMI 和总身体脂肪明显低于 HEU 儿童，但 HIV 感染儿童的体脂分布呈现出与心血管疾病风险相关的模式，可能与特定的抗逆转录病毒药物有关。
Zotero 插件