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HIV阳性患者内收拇指肌厚度与人体测量学及免疫学参数之间的关联

Association between adductor pollicis muscle thickness, anthropometric and immunological parameters in HIV-positive patients.

作者信息

Cortez Arthur Fernandes, Tolentino Julio Cesar, Aguiar Marília Ribeiro de Azevedo, Elarrat Rodrigo Moura, Freitas Passos Roberta Benitez

机构信息

Department of Internal Medicine of the Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Hospital Universitário Gaffrée and Guinle, Rua Mariz e Barros, 775, Tijuca, Rio de Janeiro-RJ 20270-004, Brazil.

Department of Internal Medicine of the Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Hospital Universitário Gaffrée and Guinle, Rua Mariz e Barros, 775, Tijuca, Rio de Janeiro-RJ 20270-004, Brazil.

出版信息

Clin Nutr ESPEN. 2017 Feb;17:105-109. doi: 10.1016/j.clnesp.2016.09.004. Epub 2016 Oct 17.

Abstract

BACKGROUNDS AND AIMS

Involuntary weight loss and muscle mass loss among HIV-positive patients are only detectable in late stages, leading poor life quality. The reduction of adductor pollicis muscle thickness (APMT) can be easily and earlier uncovered in those cases. The purpose was to estimate APMT and compare it with immunological and anthropometric parameters of HIV-infected people.

METHODS

A crosssectional study was carried out in an University Hospital including 103 HIV-infected outpatients by subjective global assessment (SGA). Data were compared to APMT for the whole sample and between gender in univariate analysis. Besides that, simple correlation and multiple linear regression were done to check the APMT relation with gender, age, weight body, body mass index, arm circumference, CD4, CD8 and viral load.

RESULTS

The APMT average values of the dominant hand (16.2 ± 4.2 mm) and non-dominant hand (14.8 ± 4.3 mm) were lower than in the healthy population. Through stratified analysis by gender, it was found significant difference in weight, arm muscle circumference, arm muscle area, triceps skinfold thickness and arm fat area (p < 0,01 for each). In any age group, men had significantly higher dominant and non-dominant APMT values than women (p < 0.001). Although the fair correlation among cited variables and APMT of both hands, there were no correlation and no difference between the genders in regards to immunological markers (CD4, CD8 and viral load). In a prediction model to APMT values, gender was determinant in multiple linear regression.

CONCLUSIONS

In a well-nourished HIV sample by SGA with adequate CD4 counts, APMT measures of both hands were lower than in healthy people. In both hands, APMT were positively correlated with weight and male, regardless of other anthropometric data and immunologic factors.

摘要

背景与目的

HIV 阳性患者的非自愿体重减轻和肌肉量减少仅在晚期才能被检测到,这导致生活质量较差。在这些病例中,拇收肌厚度(APMT)的降低可以更容易且更早地被发现。目的是评估 APMT 并将其与 HIV 感染者的免疫学和人体测量学参数进行比较。

方法

在一家大学医院进行了一项横断面研究,通过主观全面评定法(SGA)纳入了 103 名 HIV 感染门诊患者。在单变量分析中,将数据与整个样本的 APMT 以及不同性别之间的 APMT 进行比较。此外,进行了简单相关性分析和多元线性回归,以检验 APMT 与性别、年龄、体重、体重指数、上臂围、CD4、CD8 和病毒载量之间的关系。

结果

优势手(16.2±4.2 毫米)和非优势手(14.8±4.3 毫米)的 APMT 平均值低于健康人群。通过按性别分层分析,发现体重、上臂肌肉围、上臂肌肉面积、肱三头肌皮褶厚度和上臂脂肪面积存在显著差异(每项 p<0.01)。在任何年龄组中,男性的优势手和非优势手 APMT 值均显著高于女性(p<0.001)。尽管所引用变量与双手 APMT 之间存在适度相关性,但在免疫学标志物(CD4、CD8 和病毒载量)方面,性别之间没有相关性且无差异。在 APMT 值的预测模型中,性别在多元线性回归中起决定性作用。

结论

在通过 SGA 评估营养状况良好且 CD4 计数充足的 HIV 样本中,双手的 APMT 测量值低于健康人群。无论其他人体测量数据和免疫因素如何,双手的 APMT 与体重和男性呈正相关。

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