Sanchez Alejandro, Azen Colleen, Jones Brenda, Louie Stan, Sattler Fred
Division of Infectious Diseases, Department of Medicine, The Keck School of Medicine and the School of Pharmacy of the University of Southern California, IRD Building, Room 432, 2020 Zonal Avenue, Los Angeles, CA 90033, USA.
Tuberc Res Treat. 2011;2011:346295. doi: 10.1155/2011/346295. Epub 2011 Sep 13.
Background. Tuberculosis causes inflammation and muscle wasting. We investigated how attenuation of inflammation relates to repletion of body composition during treatment in an underserved population. Design. Twenty-four patients (23 to 79 years old) with pulmonary tuberculosis and inflammation (pretreatment albumin = 2.96 ± 0.13 g/dL, C-reactive protein [CRP] = 6.71 ± 1.34 μg/dL, and beta-2-microglobulin = 1.68 ± 0.10 μg/L) were evaluated and had BIA over 24 weeks. Results. Weight increased by 3.02 ± 0.81 kg (5.5%; P = 0.007) at week 4 and by 8.59 ± 0.97 kg (15.6%; P < 0.0001) at week 24. Repletion of body mass was primarily fat, which increased by 2.09 ± 0.52 kg at week 4 and 5.05 ± 0.56 kg at week 24 (P = 0.004 and P < 0.0001 versus baseline). Fat-free mass (FFM), body cell mass (BCM), and phase angle did not increase until study week 8. Albumin rose to 3.65 ± 0.14 g/dL by week 4 (P < 0.001) and slowly increased thereafter. CRP levels declined by ∼50% at each interval visit. Conclusions. During the initial treatment, acute phase reactants returned towards normal. The predominant accrual of fat mass probably reflects ongoing, low levels of inflammation.
背景。结核病会引发炎症和肌肉消耗。我们研究了在医疗服务不足人群的治疗过程中，炎症的减轻与身体成分的恢复之间的关系。设计。对24例年龄在23至79岁之间的肺结核合并炎症患者（治疗前白蛋白=2.96±0.13 g/dL，C反应蛋白[CRP]=6.71±1.34 μg/dL，β2微球蛋白=1.68±0.10 μg/L）进行评估，并在24周内进行生物电阻抗分析（BIA）。结果。第4周时体重增加了3.02±0.81 kg（5.5%；P=0.007），第24周时增加了8.59±0.97 kg（15.6%；P<0.0001）。体重的恢复主要是脂肪，第4周时增加了2.09±0.52 kg，第24周时增加了5.05±0.56 kg（与基线相比，P=0.004和P<0.0001）。直到研究第8周，去脂体重（FFM）、身体细胞质量（BCM）和相位角才开始增加。到第4周时白蛋白升至3.65±0.14 g/dL（P<0.001），此后缓慢上升。每次随访时CRP水平下降约50%。结论。在初始治疗期间急性期反应物恢复正常。脂肪量的主要增加可能反映了持续存在的低水平炎症。
