PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye M G, Magnussen P, Changalucha J, Andersen A B, Wells J C K, Friis H
Mwanza Intervention Trials Unit, Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania.
Muhimbili Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.
Eur J Clin Nutr. 2015 Oct;69(10):1125-32. doi: 10.1038/ejcn.2015.37. Epub 2015 Apr 1.
BACKGROUND/OBJECTIVES: Gains in fat mass and lean mass during tuberculosis (TB) treatment may determine functional recovery and survival; yet, data are scarce. We aimed to assess predictors of fat and fat-free mass during 2 months of intensive TB treatment in a cohort in Mwanza, Tanzania.
SUBJECTS/METHODS: Fat and fat-free mass were determined at the start of TB treatment and repeated after 2 months using the deuterium dilution technique. Gains in fat and fat-free mass were determined and predictors assessed using regression analysis.
Data for 116 patients were available at baseline and during follow-up. Of these, 38.8% were females, mean age was 37.3 (s.d. 13.5) years, 69% (81) had sputum-positive TB, 45.7% (53) were HIV infected and 25% (29) were current smokers. The mean weight gain was 3.3 kg (95% confidence interval: 2.7; 3.8), and it did not differ by sex. However, compared with females, males had 1.0 (0.4; 1.6) kg/m(2) lower fat mass but 0.7 (0.2; 1.3) kg/m(2) higher fat-free mass gain. Current smoking was associated with higher fat mass (0.7 kg/m(2), 0.04; 1.4) but lower fat-free mass (-0.5 kg/m(2), -1.2; 0.07) gain. Among HIV-infected patients, antiretroviral therapy (ART) led to a lower fat gain (-1.2 kg/m(2), -2.2; -0.2) but to a higher fat-free mass among sputum-negative (2.9 kg/m(2), 0.8; 5.1) but not sputum-positive patients.
During intensive phase of TB treatment, sex, smoking and ART were predictors of body composition. Larger studies are needed to further understand predictors of body composition during recovery, to help design interventions to improve treatment outcomes.
背景/目的：结核病（TB）治疗期间脂肪量和去脂体重的增加可能决定功能恢复和生存情况；然而，相关数据稀少。我们旨在评估坦桑尼亚姆万扎一个队列中结核病强化治疗2个月期间脂肪和去脂体重的预测因素。
对象/方法：在结核病治疗开始时测定脂肪和去脂体重，并在2个月后使用氘稀释技术重复测定。确定脂肪和去脂体重的增加情况，并使用回归分析评估预测因素。
116例患者在基线和随访期间的数据可用。其中，38.8%为女性，平均年龄为37.3（标准差13.5）岁，69%（81例）痰涂片阳性结核病患者，45.7%（53例）感染HIV，25%（29例）为当前吸烟者。平均体重增加3.3kg（95%置信区间：2.7；3.8），且无性别差异。然而，与女性相比，男性脂肪量低1.0（0.4；1.6）kg/m²，但去脂体重增加高0.7（0.2；1.3）kg/m²。当前吸烟与较高的脂肪量（0.7kg/m²，0.04；1.4）相关，但与较低的去脂体重增加（-0.5kg/m²，-1.2；0.07）相关。在HIV感染患者中，抗逆转录病毒疗法（ART）导致脂肪增加较低（-1.2kg/m²，-2.2；-0.2），但在痰涂片阴性患者中去脂体重较高（2.9kg/m²，0.8；5.1），而痰涂片阳性患者则不然。
在结核病治疗强化期，性别、吸烟和抗逆转录病毒疗法是身体组成的预测因素。需要开展更大规模的研究，以进一步了解康复期间身体组成的预测因素，帮助设计改善治疗结果的干预措施。
