Wasting among Uganda men with pulmonary tuberculosis is associated with linear regain in lean tissue mass during and after treatment in contrast to women with wasting who regain fat tissue mass: prospective cohort study

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• 作者：Ezekiel Mupere (10) (12)
  LaShaunda Malone (11)
  Sarah Zalwango (12)
  Alphonse Okwera (12)
  Mary Nsereko (12)
  Daniel J Tisch (13)
  Isabel M Parraga (14)
  Catherine M Stein (11) (13)
  Roy Mugerwa (12) (15)
  W Henry Boom (11)
  Harriet K Mayanja (12) (15)
  Christopher C Whalen (16)
  Tuberculosis Research Unit at Case Western Reserve University
  
  10. Department of Paediatrics & Child Health College of Health Sciences ; Makerere University Kampala ; Kampala ; Uganda
  12. Uganda-Case Western Reserve Research Collaboration ; Kampala ; Uganda
  11. Tuberculosis Research Unit ; Case Western Reserve University ; Cleveland ; USA
  13. Department of Epidemiology & Biostatistics ; Case Western Reserve University ; Cleveland ; USA
  14. Department of Nutrition ; Case Western Reserve University ; Cleveland ; USA
  15. Department of Internal Medicine College of Health Sciences ; Makerere University ; Kampala ; Uganda
  16. Department of Epidemiology & Biostatistics College of Public Health ; University of Georgia Athens ; Athens ; USA
  
• 关键词：Tuberculosis ; HIV ; Wasting ; Lean tissue mass index ; Fat mass index ; Body mass index ; Gender
• 刊名：BMC Infectious Diseases
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：1,104 KB
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  56. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2334/14/24/prepub
  
• 刊物主题：Infectious Diseases; Parasitology; Medical Microbiology; Tropical Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2334

文摘

Background Nutritional changes during and after tuberculosis treatment have not been well described. We therefore determined the effect of wasting on rate of mean change in lean tissue and fat mass as measured by bioelectrical impedance analysis (BIA), and mean change in body mass index (BMI) during and after tuberculosis treatment. Methods In a prospective cohort study of 717 adult patients, BMI and height-normalized indices of lean tissue (LMI) and fat mass (FMI) as measured by BIA were assessed at baseline, 3, 12, and 24 months. Results Men with wasting at baseline regained LMI at a greater rate than FMI (4.55 kg/m2 (95% confidence interval (CI): 1.26, 7.83 versus 3.16 (95% CI: 0.80, 5.52)) per month, respectively during initial tuberculosis therapy. In contrast, women with wasting regained FMI at greater rate than LMI (3.55 kg/m2 (95% CI: 0.40, 6.70) versus 2.07 (95% CI: -0.74, 4.88)), respectively. Men with wasting regained BMI at a rate of 6.45 kg/m2 (95% CI: 3.02, 9.87) in the first three months whereas women, had a rate of 3.30 kg/m2 (95% CI: -0.11, 6.72). There were minimal changes in body composition after month 3 and during months 12 to 24. Conclusion Wasted tuberculosis patients regain weight with treatment but the type of gain differs by gender and patients may remain underweight after the initial phase of treatment.