National Institute for Medical Research, Mwanza Centre, Tanzania.
J Nutr. 2013 May;143(5):735-41. doi: 10.3945/jn.112.168997. Epub 2013 Mar 20.
Underweight is common among tuberculosis (TB) patients. However, there is little information on determinants of body composition at TB treatment initiation in high-TB-burdened countries. This study aimed to determine factors associated with body composition at commencement of TB treatment in Mwanza, Tanzania. A cross-sectional study was conducted from 2007 to 2008 among newly diagnosed TB patients. Fat and fat-free mass were determined using a deuterium dilution technique and fat and fat-free mass indices were computed. Correlates were assessed using multiple regression analysis. A total of 201 pulmonary TB patients were recruited; of these, 37.8% (76) were female, 51.7% (104) were HIV infected, 65.3% (126) had sputum-positive TB, and 24.4% (49) were current smokers. In multiple regressions analysis, males had a 2.2-kg/m(2) [(95% CI = 1.6, 2.9); P < 0.0001] lower fat mass index but 1.5 kg/m(2) [(95% CI = 0.9, 2.0); P < 0.0001] higher fat-free mass index compared with females. Sputum-positive TB was associated with a lower fat mass index among HIV-uninfected patients [-1.4 kg (95% CI = -2.5, -0.4); P = 0.006] but not among HIV-infected patients (P-interaction = 0.09). Current smokers had a 0.7-kg/m(2) [(95% CI = 0.02, 1.5); P = 0.045] lower fat mass index, but smoking did not affect fat-free mass. High socioeconomic status (SES) was associated with higher fat as well as fat-free mass. HIV infection, cluster of differentiation 4 count, and antiretroviral therapy were not correlates. Sex, smoking, and SES were associated with body composition of TB patients at treatment commencement. Prospective studies are needed to determine the role of these factors on weight gain, functional recovery, and survival during and after treatment.
在结核病（TB）患者中，体重过轻很常见。然而，在高结核病负担国家，关于治疗开始时身体成分决定因素的信息很少。本研究旨在确定坦桑尼亚姆万扎在开始结核病治疗时与身体成分相关的因素。2007 年至 2008 年期间，进行了一项横断面研究，对象为新诊断的结核病患者。使用氘稀释技术确定脂肪和无脂肪质量，并计算脂肪和无脂肪质量指数。使用多元回归分析评估相关因素。共招募了 201 例肺结核患者；其中，37.8%（76 例）为女性，51.7%（104 例）为 HIV 感染者，65.3%（126 例）为痰阳性结核病患者，24.4%（49 例）为当前吸烟者。在多元回归分析中，男性的脂肪量指数比女性低 2.2-kg/m(2)[95%CI = 1.6, 2.9); P < 0.0001]，但脂肪游离量指数高 1.5 kg/m(2)[95%CI = 0.9, 2.0); P < 0.0001]。痰阳性结核病与 HIV 未感染者的脂肪量指数较低相关[-1.4 kg（95%CI = -2.5, -0.4）；P = 0.006]，但与 HIV 感染者无关（P 交互= 0.09）。当前吸烟者的脂肪量指数低 0.7-kg/m(2)[95%CI = 0.02, 1.5); P = 0.045]，但不影响脂肪游离量。高社会经济地位（SES）与脂肪和脂肪游离量均呈正相关。CD4 计数和抗逆转录病毒治疗与这些因素无关。性别、吸烟和 SES 与治疗开始时结核病患者的身体成分有关。需要前瞻性研究来确定这些因素对治疗期间和治疗后的体重增加、功能恢复和生存的作用。
