HIV 感染者的饮食质量低，且存在性别差异。
Diet Quality Is Low and Differs by Sex in People with HIV.
机构信息
Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Translational and Clinical Research Center, Massachusetts General Hospital, Boston, MA.
出版信息
J Nutr. 2019 Jan 1;149(1):78-87. doi: 10.1093/jn/nxy241.
BACKGROUND
People with HIV (PWH) are at risk for developing metabolic comorbidities driven, in part, by immune activation/inflammation. Little is known about diet quality, a potential modifiable factor in PWH.
OBJECTIVES
This study aimed to explore diet quality in terms of conformance with US dietary guidelines by calculating Healthy Eating Index-2010 (HEI) scores among adults with and without HIV in Boston, MA, and determine associations with HEI and markers of immune activation/inflammation.
METHODS
One-hundred and three HIV-infected [50 women, 53 men; mean ± SD age: 47 ± 7 y; body mass index (BMI, in kg/m2): 26 ± 5] and 38 uninfected adults (17 women, 21 men; age: 46 ± 7 y; BMI: 28 ± 4) were included in this cross-sectional analysis. Participants who completed a 4-d food record from which HEI could be calculated were included. HEI was compared between participants with and without HIV, within HIV-infected participants stratified by sex, and by HIV serostatus and sex. In the HIV group, predictors of HEI were determined in multivariable modeling. Univariate associations with diet quality and inflammation/immune markers were assessed.
RESULTS
The HEI score was 51.3 in the HIV-infected participants and 57.3 in the HIV-uninfected participants (P = 0.052). In the comparison by HIV serostatus and sex, HIV-infected women had significantly lower HEI (49.2) compared with HIV-infected men (55.7) (P = 0.005) and HIV-uninfected men (61.8) (P = 0.002). Adjusting for potential confounding factors, sex remained an independent predictor of HEI in HIV (P = 0.02). In the HIV group, higher log HEI was associated with lower concentration of the immune activation marker sCD14 (P = 0.009).
CONCLUSIONS
Diet quality tended to be lower in HIV-infected individuals compared with HIV-uninfected individuals and was lower among HIV-infected women compared with HIV-infected men, and HIV-uninfected men. There may also be an association with diet quality and sCD14 in PWH. Future prospective studies are needed to confirm these findings and determine whether improving diet quality is a useful strategy to reduce metabolic abnormalities in this population. This study was registered at clinicaltrials.gov as NCT00455793.
背景
艾滋病毒感染者（PWH）存在发生代谢合并症的风险，这部分是由免疫激活/炎症引起的。人们对饮食质量知之甚少，饮食质量是 PWH 潜在的可改变因素之一。
目的
本研究旨在通过计算马萨诸塞州波士顿的 HIV 感染者和未感染者的健康饮食指数-2010（HEI）评分，探讨饮食质量与美国饮食指南的符合程度，并确定与 HEI 和免疫激活/炎症标志物的关联。
方法
本横断面研究纳入了 103 名 HIV 感染者（50 名女性，53 名男性；平均年龄±标准差：47±7 岁；体重指数（BMI，kg/m2）：26±5）和 38 名未感染者（17 名女性，21 名男性；年龄：46±7 岁；BMI：28±4）。本研究纳入了完成了 4 天食物记录并可以计算 HEI 的参与者。比较了 HIV 感染者和未感染者、HIV 感染者按性别分层、HIV 感染者按 HIV 血清学状态和性别分层的 HEI。在 HIV 组中，采用多元模型确定了 HEI 的预测因素。评估了与饮食质量和炎症/免疫标志物的单变量关联。
结果
HIV 感染者的 HEI 评分为 51.3，HIV 未感染者的 HEI 评分为 57.3（P=0.052）。按 HIV 血清学状态和性别比较，HIV 感染女性的 HEI 明显低于 HIV 感染男性（55.7）（P=0.005）和 HIV 未感染男性（61.8）（P=0.002）。调整潜在混杂因素后，性别仍是 HIV 患者 HEI 的独立预测因素（P=0.02）。在 HIV 组中，较高的 log HEI 与免疫激活标志物 sCD14 的浓度降低相关（P=0.009）。
结论
与 HIV 未感染者相比，HIV 感染者的饮食质量往往较低，与 HIV 未感染者男性相比，HIV 感染女性的饮食质量也较低。在 PWH 中，饮食质量可能与 sCD14 有关。需要进一步的前瞻性研究来证实这些发现，并确定改善饮食质量是否是降低该人群代谢异常的有效策略。本研究在 clinicaltrials.gov 注册，编号为 NCT00455793。
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