Keshani Parisa, Sarihi Sorour, Parsaie Narges, Joulaei Hassan
Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Human Nutrition and Hospitality Management, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA.
J Public Health Res. 2023 Jun 26;12(2):22799036231181200. doi: 10.1177/22799036231181200. eCollection 2023 Apr.
Considering contradictory reports about the impact of dietary pattern on CD4 cell count in previous studies and the potential importance of diet on the immune system, this study aimed to assess the association between dietary patterns and CD4 count among HIV-infected patients.
This cross-sectional study was conducted among HIV-infected patients aged 18-60 who registered in the referral Voluntary Counseling and Testing Center of Shiraz, Iran. The principal component analysis identified nutritional patterns and factors. The association between the score of the dietary patterns and CD4 count was considered in two categories of CD4 more/less than 500 and using backward logistic regression after adjusting for confounders.
A total of 226 participants were included in the analysis. CD4 was significantly lower in males ( < 0.001). Participants with illegal drug use ( < 0.001), HCV ( = 0.001), and HBV ( < 0.001) had lower serum CD4. Four extracted dietary patterns were a Plant-rich diet, Healthy animal-based proteins, a Western diet, and Affordable calorie and protein patterns. There was an association between CD4 and Western diet patterns in the best model in which age, gender, weight, and HBV were included. Each unit increase in Western diet score increased the odds of CD4 less than 500 by 57% (OR = 1.57; CI 95% 1.06-2.34, = 0.02).
Among the four dietary patterns, the Western diet comprising a high intake of refined sugar and grain, saturated and trans fats, and animal protein sources, especially high-fat red meat, had a statistically significant relationship with a decrease in CD4 cell count.
鉴于先前研究中关于饮食模式对CD4细胞计数影响的报道相互矛盾，以及饮食对免疫系统的潜在重要性，本研究旨在评估HIV感染患者的饮食模式与CD4计数之间的关联。
本横断面研究在伊朗设拉子转诊自愿咨询和检测中心登记的18至60岁HIV感染患者中进行。主成分分析确定了营养模式和因素。在调整混杂因素后，将饮食模式得分与CD4计数之间的关联分为CD4大于/小于500两类，并使用向后逻辑回归进行分析。
共有226名参与者纳入分析。男性的CD4显著较低（<0.001）。有非法药物使用史（<0.001）、丙型肝炎病毒（HCV，=0.001）和乙型肝炎病毒（HBV，<0.001）的参与者血清CD4较低。提取的四种饮食模式为富含植物的饮食、健康的动物蛋白饮食、西方饮食以及经济实惠的热量和蛋白质模式。在纳入年龄、性别、体重和HBV的最佳模型中，CD4与西方饮食模式之间存在关联。西方饮食得分每增加一个单位，CD4小于500的几率增加57%（OR=1.57；95%CI 1.06-2.34，=0.02）。
在这四种饮食模式中，西方饮食（包括高摄入精制糖和谷物、饱和脂肪和反式脂肪以及动物蛋白来源，尤其是高脂肪红肉）与CD4细胞计数下降存在统计学上的显著关系。
