Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK.
Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia 74605-050, Brazil.
Nutrients. 2020 Sep 28;12(10):2970. doi: 10.3390/nu12102970.
Antiretroviral therapy (ART) increases the risk of cardiometabolic diseases in people living with HIV/AIDS (PLWHA). However, there is a lack of evidence regarding the effectiveness of a nutritional intervention on several cardiometabolic parameters in this population. Therefore, this study aimed to evaluate the effectiveness of two nutritional interventions on several cardiometabolic parameters in PLWHA treated with ART. A parallel randomized clinical trial was performed with PLWHA treated with ART. The participants ( = 88) were divided into two intervention groups: (1) nutritional counseling ( = 44) and (2) individualized dietary prescription ( = 44). The follow-up period was 30 weeks. A reduction in low-density lipoprotein (LDL) was the primary outcome. Secondary outcome variables were reductions in total cholesterol (TC), triglycerides (TG), fasting plasma glucose (FPG), systolic and diastolic blood pressures (SBP and DBP, respectively), waist circumference (WC), body mass index (BMI), and increases in high-density lipoproteins (HDL). A multiple linear regression was used to analyze the effectiveness of the interventions, adjusted for sociodemographic, lifestyle, and clinical characteristics. Sixty-two PLWHA completed the trial (nutritional counseling, = 32; individualized dietary prescription, = 30). At follow-up, we observed in the nutritional counseling group significant reductions in SBP ( = 0.036) and DBP ( = 0.001). Significant reductions in FPG ( = 0.008) and DBP ( = 0.023) were found in the individualized dietary prescription group. In the fully adjusted models, significant reductions in LDL, SBP, DBP, and BMI were found in the individualized dietary prescription group. In conclusion, the two investigated nutritional interventions were effective in reducing some cardiometabolic risk factors in PLWHA. However, after adjustments for covariates, the individualized dietary prescription showed significant reductions in the primary outcome and, also, in more cardiometabolic risk factors than the nutritional counseling.
抗逆转录病毒疗法(ART)会增加艾滋病毒/艾滋病(PLWHA)患者患心血管代谢疾病的风险。然而,对于营养干预对该人群的多项心血管代谢参数的有效性,目前还缺乏证据。因此,本研究旨在评估两种营养干预措施对接受 ART 治疗的 PLWHA 的多项心血管代谢参数的有效性。进行了一项平行随机临床试验,研究对象为接受 ART 治疗的 PLWHA。参与者(n=88)分为两组干预组:(1)营养咨询(n=44)和(2)个体化饮食处方(n=44)。随访期为 30 周。降低低密度脂蛋白(LDL)是主要结局。次要结局变量包括总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、收缩压和舒张压(SBP 和 DBP)、腰围(WC)、体重指数(BMI)和高密度脂蛋白(HDL)的增加。采用多元线性回归分析干预措施的有效性,调整了社会人口统计学、生活方式和临床特征。62 名 PLWHA 完成了试验(营养咨询组 n=32;个体化饮食处方组 n=30)。随访时,我们观察到营养咨询组的 SBP(=0.036)和 DBP(=0.001)显著降低。个体化饮食处方组的 FPG(=0.008)和 DBP(=0.023)显著降低。在完全调整模型中,个体化饮食处方组的 LDL、SBP、DBP 和 BMI 显著降低。总之,两种研究的营养干预措施均能有效降低 PLWHA 的一些心血管代谢危险因素。然而,在调整协变量后,个体化饮食处方组在主要结局和更多心血管代谢危险因素方面的降低效果均优于营养咨询组。