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与 HIV 阴性个体相比,营养状况良好的老年亚洲 HIV 感染者中异常营养状况的比例更高。

Higher Proportion of Abnormal Nutritional Status Among Well-Suppressed HIV-Infected Elderly Asians Compared to HIV-Negative Individuals.

机构信息

HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

Division of Cardiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

AIDS Res Hum Retroviruses. 2020 Jul;36(7):590-596. doi: 10.1089/AID.2019.0285. Epub 2020 Mar 25.

Abstract

Older adults face physiological, psychological, social, and economic changes, which may impair nutritional status, making the body vulnerable to illness and adverse clinical outcomes. Little is known regarding the nutritional status among elderly people living with HIV (PLHIV). We aimed to study the prevalence of malnutrition and the associated factors in a Thai aging cohort. A cross-sectional study was conducted among PLHIV >50 years of age on long-term antiretroviral therapy and HIV-negative controls, frequency matched by sex and age in Bangkok, Thailand. Nutritional status was assessed by the Mini Nutrition Assessment (MNA) tool. Abnormal nutritional status was defined as MNA score <24 (malnutrition and at risk of malnutrition). Body composition was measured by bioelectrical impedance analysis using Body Composition Analyzer. Demographic and disease-related factors were assessed for their association with abnormal nutrition status using multivariable logistic regression. There were 349 PLHIV and 103 HIV-uninfected controls, with median age 55 years. The majority were male (63%) with median body mass index (BMI) of 23.4 kg/m. PLHIV had lower BMI [median, 23.1 (IQR, 20.8-25.2) vs. 25.3 (22.3-28.7) kg/m,  < .001], lower fat percent [22.8% vs. 26.3%,  < .001] and lower fat mass [14.2 vs. 16.9 kg,  < .001] and higher abnormal nutritional status (18.05% vs. 6.8%,  = .005) than controls. In the multivariate model, older age (adjusted odds ratio [aOR], 1.06, 95% confident interval [CI]: 1.01-1.12,  = .03), positive HIV status (aOR, 2.67, 95% CI: 1.07-6.65,  = .036), diabetes mellitus (aOR, 2.21, 95% CI: 1.003-4.87,  = .049), lower fat mass (aOR, 0.70, 95%CI: 0.57-0.86,  < .001), and lower BMI (aOR, 0.63, 95% CI: 0.51-0.78,  < .001) were independently associated with abnormal nutritional status. PLHIV had higher risks for abnormal nutritional status compared with HIV-uninfected individuals. Regular screening and monitoring of nutritional status among PLHIV may promote better health outcomes.

摘要

老年人面临着生理、心理、社会和经济变化,这些变化可能会损害营养状况,使身体容易患病和出现不良临床结局。关于感染艾滋病毒的老年人(PLHIV)的营养状况知之甚少。我们旨在研究泰国老龄化队列中营养不良的流行情况和相关因素。在曼谷,对接受长期抗逆转录病毒治疗的年龄在 50 岁及以上的 PLHIV 和 HIV 阴性对照者进行了一项横断面研究,这些对照者按性别和年龄进行了频率匹配。营养状况通过微型营养评估(MNA)工具进行评估。异常营养状况定义为 MNA 评分<24(营养不良和有营养不良风险)。使用身体成分分析仪通过生物电阻抗分析测量身体成分。使用多变量逻辑回归评估人口统计学和疾病相关因素与异常营养状况的关联。共有 349 名 PLHIV 和 103 名未感染 HIV 的对照者,中位年龄为 55 岁。大多数是男性(63%),中位体重指数(BMI)为 23.4kg/m。PLHIV 的 BMI 较低[中位数,23.1(IQR,20.8-25.2)与 25.3(22.3-28.7)kg/m,<0.001],脂肪百分比较低[22.8%比 26.3%,<0.001],脂肪量较低[14.2 比 16.9kg,<0.001],异常营养状况较高(18.05%比 6.8%,=0.005)。在多变量模型中,年龄较大(调整后的优势比[OR],1.06,95%置信区间[CI]:1.01-1.12,=0.03),HIV 阳性(OR,2.67,95%CI:1.07-6.65,=0.036),糖尿病(OR,2.21,95%CI:1.003-4.87,=0.049),脂肪量较低(OR,0.70,95%CI:0.57-0.86,<0.001)和 BMI 较低(OR,0.63,95%CI:0.51-0.78,<0.001)与异常营养状况独立相关。与未感染 HIV 的个体相比,PLHIV 发生异常营养状况的风险更高。定期筛查和监测 PLHIV 的营养状况可能会促进更好的健康结果。

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