Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan.
Department of Infectious Diseases, University Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan.
Medicine (Baltimore). 2022 Oct 21;101(42):e31349. doi: 10.1097/MD.0000000000031349.
To investigate the prevalence of sarcopenia among people living with HIV (PLWH) in Japan and analyze the relationship between HIV infection and ART effects on the body composition of Japanese PLWH for more appropriate drug selection and lifestyle guidance. Cross-sectional observational study. We included male patients aged ≥ 60 years whose body composition was measured by InBody 570 body composition analyzer during outpatient visits. Patients were classified by body shape based on body mass index (BMI) and body fat percentage measurements and by tenofovir alafenamide administration. Hidden obesity is a condition wherein the BMI is within the standard range but the body fat percentage is higher than the reference. Patients with low muscle mass and strength were considered to have sarcopenia, whereas those with only low muscle strength were considered to have pre-sarcopenia. In total, 87 patients were included. Based on body shape determined by BMI and body fat percentage, most patients had hidden obesity (40 patients, 46.0%). Sarcopenia was detected in 9 patients (10.3%) and pre-sarcopenia in 14 patients (16.1%). The tenofovir alafenamide (TAF) use group had significantly higher BMI, higher skeletal muscle mass, body fat mass, and skeletal muscle mass index relative to the non-TAF use group. Hidden obesity is a risk for lifestyle diseases. It is important to recognize it based on body composition measurements because it can be missed by BMI measurement alone. Tenofovir alafenamide therapy increases skeletal muscle mass, which may result in the prevention of sarcopenia. To clarify how TAF affects the development of sarcopenia and lifestyle diseases, future studies on a larger cohort are warranted.
调查日本 HIV 感染者（PLWH）中肌少症的流行情况，并分析 HIV 感染与 ART 对日本 PLWH 身体成分的影响，以便更合理地选择药物和指导生活方式。
这是一项横断面观察性研究。我们纳入了在门诊就诊时通过 InBody 570 身体成分分析仪测量身体成分的年龄≥60 岁的男性患者。根据 BMI 和体脂百分比的测量值以及替诺福韦艾拉酚胺的使用情况，将患者进行体型分类。隐性肥胖是指 BMI 在正常范围内，但体脂百分比高于参考值的情况。肌肉量和力量低的患者被认为患有肌少症，而仅有肌肉力量低的患者被认为患有肌少前症。
共纳入 87 例患者。根据 BMI 和体脂百分比确定的体型，大多数患者存在隐性肥胖（40 例，46.0%）。9 例（10.3%）患者检测出肌少症，14 例（16.1%）患者检测出肌少前症。与未使用替诺福韦艾拉酚胺的患者相比，使用替诺福韦艾拉酚胺的患者 BMI 更高，骨骼肌质量、体脂肪质量和骨骼肌质量指数更高。
隐性肥胖是导致生活方式相关疾病的危险因素。基于身体成分测量来识别它很重要，因为仅 BMI 测量可能会漏诊。替诺福韦艾拉酚胺治疗可增加骨骼肌质量，从而可能预防肌少症。为了阐明替诺福韦艾拉酚胺如何影响肌少症和生活方式相关疾病的发生，有必要在更大的队列中开展未来的研究。
