Department of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA.
J Acad Nutr Diet. 2013 Aug;113(8):1037-43. doi: 10.1016/j.jand.2013.02.005. Epub 2013 Apr 16.
Several studies have reported increased resting energy expenditure (REE) in people with human immunodeficiency virus (HIV). However, limited data exist on REE in HIV-infected women and the effect of antiretroviral therapy (ART) on REE in this population.
The purpose of this study was to compare REE in healthy controls to adult HIV-infected women classified in three groups: naïve to ART, on ART with virologic suppression, and on ART with an HIV-1 RNA level >5,000 copies/mL.
After a fast, body composition by bioelectrical impedance analysis and REE by indirect calorimetry were determined. Anthropometric measures were also taken.
Distributionally appropriate two-sample tests were used for between-group analyses and analysis of covariance was used for confounding adjustment.
Eighty-seven women were enrolled and the HIV-infected and control women were matched for age and body mass index. Log-transformed REE was significantly higher in HIV-infected women naïve to ART compared to controls (7.26±0.22 vs 7.14±0.19; P=0.04, respectively) and the difference remained significant after adjustment for body cell mass (P=0.008). Log-transformed REE was not different in HIV-infected women on ART compared to HIV-infected women naïve to ART (7.25±0.25 vs 7.26±0.23; P=0.81, respectively). Adjusting for body cell mass did not change the results (P=0.56). Similarly, REE was not different between women naïve to ART and those on ART with undetectable HIV-1 RNA, regardless of adjustment for body cell mass. REE correlated to current and nadir CD4 count and trended toward a negative correlation with HIV-1 RNA levels.
We showed that REE is elevated in ART-naïve, HIV-infected women and continues to be elevated when on ART, regardless of virologic suppression, compared to age and body mass index-matched healthy women. This suggests an effect of HIV infection itself and not ART on REE in these HIV-infected women, and should be considered during nutrition assessment and counseling of HIV-infected adult women.
多项研究报告称，人类免疫缺陷病毒（HIV）感染者的静息能量消耗（REE）增加。然而，HIV 感染者的 REE 数据有限，以及抗逆转录病毒疗法（ART）对该人群 REE 的影响。
本研究旨在比较健康对照组与三组 HIV 感染成年女性的 REE：未接受 ART、接受 ART 且病毒学抑制、以及接受 ART 但 HIV-1 RNA 水平>5000 拷贝/ml。
禁食后，通过生物电阻抗分析测定身体成分，通过间接热量法测定 REE。还进行了人体测量学测量。
使用适用于分布的两样本检验进行组间分析，使用协方差分析进行混杂因素调整。
共纳入 87 名女性，HIV 感染者和对照组女性在年龄和体重指数方面相匹配。与对照组相比，未接受 ART 的 HIV 感染者的 REE 明显更高（7.26±0.22 与 7.14±0.19；P=0.04），调整细胞内液量后差异仍然显著（P=0.008）。与未接受 ART 的 HIV 感染者相比，接受 ART 的 HIV 感染者的 REE 无差异（7.25±0.25 与 7.26±0.23；P=0.81），调整细胞内液量后结果无变化（P=0.56）。同样，未接受 ART 和病毒学抑制的 HIV 感染者的 REE 无差异，无论是否调整细胞内液量。REE 与当前和最低 CD4 计数相关，与 HIV-1 RNA 水平呈负相关趋势。
我们表明，与年龄和体重指数匹配的健康女性相比，ART 初治的 HIV 感染者的 REE 升高，且无论病毒学抑制如何，接受 ART 后 REE 仍持续升高。这表明 HIV 感染本身而不是 ART 对这些 HIV 感染者的 REE 有影响，在评估 HIV 感染成年女性的营养状况和提供咨询时应予以考虑。
