腹型肥胖、肌肉减少症和骨质疏松症与 HIV 感染者和非感染者的虚弱有关。
Abdominal obesity, sarcopenia, and osteoporosis are associated with frailty in men living with and without HIV.
机构信息
University of Colorado, Aurora.
Denver Public Health, Denver, Colorado.
出版信息
AIDS. 2018 Jun 19;32(10):1257-1266. doi: 10.1097/QAD.0000000000001829.
OBJECTIVE
The relationships between frailty and body composition in older adults with HIV infection are poorly understood. We sought to describe associations between frailty and measures of body composition among adult men with HIV and without HIV.
DESIGN/METHODS: Men with and without HIV (age 50-69 years) in the Multicenter AIDS Cohort Study (MACS) Bone Strength Substudy were included if evaluated for frailty (by Fried phenotype) and body composition [BMI, waist circumference, abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, sarcopenia, and osteopenia/osteoporosis]. All participants with HIV infection were on antiretroviral therapy. Multivariate multinomial logistic regression models were used to determine associations of frailty with body composition.
RESULTS
A total of 399 men, including 199 men with HIV and 200 men without HIV, both with median age 60 years, constituted our study population. Frailty prevalence was 16% (men with HIV) vs. 8% (men without HIV). HIV serostatus was associated with a 2.43 times higher odds of frailty (P = 0.01). Higher waist circumference, VAT, sarcopenia, and femoral neck osteoporosis were associated with increased odds of frailty (aOR 4.18, 4.45, 4.15, and 13.6, respectively, and all P < 0.05); BMI and SAT were not. None of these measures presented a differential association with frailty by HIV serostatus (all P > 0.20).
CONCLUSION
Higher abdominal obesity and sarcopenia were associated with frailty among men with and without HIV. Assessment of these body composition parameters may help detect frailty in the clinical setting.
目的
老年人 HIV 感染者的虚弱与身体成分之间的关系尚未完全明确。本研究旨在描述 HIV 感染者与非 HIV 感染者中虚弱与身体成分测量指标之间的相关性。
方法/设计：如果对（通过 Fried 表型）评估虚弱和身体成分[BMI、腰围、腹部内脏（VAT）和皮下（SAT）脂肪组织、肌少症和骨质疏松/骨量减少]，则将患有和未患有 HIV 的 50-69 岁 MACS 骨骼强度子研究中的男性纳入多中心 AIDS 队列研究（MACS）。所有感染 HIV 的患者均接受抗逆转录病毒治疗。使用多变量多项逻辑回归模型来确定虚弱与身体成分之间的相关性。
结果
共有 399 名男性，包括 199 名 HIV 感染者和 200 名非 HIV 感染者，中位年龄均为 60 岁，构成了我们的研究人群。虚弱的患病率为 16%（HIV 感染者）与 8%（非 HIV 感染者）。HIV 血清阳性与虚弱的可能性增加 2.43 倍相关（P=0.01）。较高的腰围、VAT、肌少症和股骨颈骨质疏松症与虚弱的可能性增加相关（分别为 OR 4.18、4.45、4.15 和 13.6，均 P<0.05）；BMI 和 SAT 则不然。这些措施均未通过 HIV 血清阳性表现出与虚弱的差异相关性（均 P>0.20）。
结论
较高的腹部肥胖和肌少症与 HIV 感染者和非 HIV 感染者的虚弱有关。在临床环境中评估这些身体成分参数可能有助于发现虚弱。
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