Erlandson Kristine M, Reynolds Sandra M, Cox Christopher, Palella Frank J, Witt Mallory D, Kingsley Lawrence A, Brown Todd T, Plankey Michael
Department of Medicine, Divisions of Infectious Diseases & Geriatric Medicine, University of Colorado, Aurora, Colorado, United States of America.
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
PLoS One. 2014 Dec 1;9(12):e114166. doi: 10.1371/journal.pone.0114166. eCollection 2014.
Self-perception of changes in body fat among HIV+ persons is associated with decreased health related quality of life in cross-sectional studies. The longitudinal impact of body fat changes on health related quality of life, while accounting for comorbidity and anatomic location or severity of body fat changes, is unknown.
This was a longitudinal analysis of HIV+ and HIV- Multicenter AIDS Cohort Study (MACS) participants who completed questionnaires assessing self-perceived body fat changes (baseline visit) and a health related quality of life (Short Form-36) at baseline and then ≥5 years later.
Relationships between body fat changes and change in Short Form-36 Physical and Mental Component Summary scores were investigated using mixed-model regression.
We studied 270 HIV+ and 247 HIV- men. At baseline, ≥50% of HIV+ men reported body fat changes; physical component but not mental component summary scores were lower among HIV+ men who reported moderate/severe leg or abdominal fat changes (p<0.05). At follow-up, physical component summary scores were significantly lower among men with face, leg, or abdominal fat changes compared to men without perceived fat changes (p<0.05). No significant changes were seen in mental component scores by fat change location or severity. In the final model, body fat changes at any site or severity were significant predictors of a decline in physical component summary score (p<0.05), independent of demographics or comorbidities. Mental component summary score was not associated with body fat changes, but higher mental component summary score was associated with increasing age and time.
Negative self-perceived body fat changes were associated with decline in physical health related quality of life, independent of comorbidities, and may be a marker of an increased risk for physical function decline with aging.
在横断面研究中，HIV感染者对身体脂肪变化的自我认知与健康相关生活质量下降有关。身体脂肪变化对健康相关生活质量的纵向影响尚不清楚，同时也未考虑合并症以及身体脂肪变化的解剖位置或严重程度。
这是一项对HIV感染者和未感染HIV者的多中心艾滋病队列研究（MACS）参与者的纵向分析，这些参与者完成了评估自我感知身体脂肪变化（基线访视）以及基线时和≥5年后的健康相关生活质量（简短形式-36）的问卷。
使用混合模型回归研究身体脂肪变化与简短形式-36身体和心理成分总结得分变化之间的关系。
我们研究了270名HIV感染者和247名未感染HIV的男性。在基线时，≥50%的HIV感染者报告有身体脂肪变化；报告有中度/重度腿部或腹部脂肪变化的HIV感染者中，身体成分总结得分较低，但心理成分总结得分无差异（p<0.05）。在随访时，与未察觉到脂肪变化的男性相比，面部、腿部或腹部有脂肪变化的男性身体成分总结得分显著更低（p<0.05）。心理成分得分在脂肪变化位置或严重程度方面未见显著变化。在最终模型中，任何部位或严重程度的身体脂肪变化都是身体成分总结得分下降的显著预测因素（p<0.05），与人口统计学或合并症无关。心理成分总结得分与身体脂肪变化无关，但心理成分总结得分越高与年龄增长和时间有关。
负面的自我感知身体脂肪变化与身体健康相关生活质量下降有关，与合并症无关，可能是衰老导致身体功能下降风险增加的一个标志。
