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年轻住院HIV感染者肌少症的预测因素

Predictors of sarcopenia in young hospitalized patients living with HIV.

作者信息

Almeida Thaise Sanches de, Cortez Arthur Fernandes, Cruz Mônica Rodrigues da, Almeida Vívian Pinto de

机构信息

Hospital Universitário João de Barros Barreto (HUJBB), Belém, PA, Brazil.

Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.

出版信息

Braz J Infect Dis. 2021 Mar-Apr;25(2):101574. doi: 10.1016/j.bjid.2021.101574. Epub 2021 Apr 13.

Abstract

The prevalence of sarcopenia in hospitalized people living with HIV is underdiagnosed, as assessment instruments are not always available. This study aimed to identify factors related to sarcopenia, correlating their anthropometric and clinical markers in hospitalized people living with HIV. This was an observational cross-sectional clinical study, carried out from September 2018 through October 2019. Handgrip strength, muscle mass index, calf circumference and gait speed test were evaluated in recruited patients within three days of hospital admission. The sample consisted in 44 patients, mostly men (66%), black (68%), young adults (41.65±12.18 years) and immunodeficient (CD4 cell count 165 cells/mm [34.25-295.5]). Sarcopenia was present in 25% of the sample. Calf circumference showed a significant correlation with CD4 cell count and viral load (p<0.05) while handgrip strength and gait speed test did not. Calf circumference>31cm and gait speed test>0.8m/s reduced the chance of sarcopenia by 60% (OR=0.396 [-1.67 to -0.18]; p<0.05) and 98% (OR=0.02 [-8.16 to 0.13]; p<0.05) respectively. Calf circumference>31cm and gait speed test>0.8m/s are associated with a reduced chance of sarcopenia in hospitalized HIV patients.

摘要

住院的艾滋病病毒感染者中肌肉减少症的患病率未得到充分诊断,因为评估工具并非总是可用。本研究旨在确定与肌肉减少症相关的因素,将其人体测量学和临床指标在住院的艾滋病病毒感染者中进行关联分析。这是一项观察性横断面临床研究,于2018年9月至2019年10月开展。在招募的患者入院三天内评估其握力、肌肉质量指数、小腿围度和步速测试。样本包括44名患者,大多数为男性(66%)、黑人(68%)、年轻人(41.65±12.18岁)且免疫功能低下(CD4细胞计数为165个细胞/mm³[34.25 - 295.5])。样本中有25%存在肌肉减少症。小腿围度与CD4细胞计数和病毒载量呈显著相关性(p<0.05),而握力和步速测试则无此相关性。小腿围度>31cm和步速测试>0.8m/s分别使肌肉减少症的发生几率降低60%(OR = 0.396 [-1.67至-0.18];p<0.05)和98%(OR = 0.02 [-8.16至0.13];p<0.05)。小腿围度>31cm和步速测试>0.8m/s与住院艾滋病病毒感染者肌肉减少症发生几率降低相关。

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