Determinants of increased energy expenditure in HIV-infected women
Determinants of increased energy expenditure in HIV-infected women
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DOI：
10.1093/ajcn/68.3.720
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发表时间：
1998-09-01
影响因子：
7.1
通讯作者：
Klibanski, A
中科院分区：
文献类型：
--
作者：
Grinspoon, S;Corcoran, C;Klibanski, A
背景：对于 HIV 感染对能量消耗的性别特异性影响知之甚少。目的：我们调查了 HIV 感染女性能量消耗的决定因素。设计：比较 33 名动态绝经前 HIV 感染女性和 26 名体重匹配的健康绝经前对照受试者的静息能量消耗 (REE)、身体成分以及激素和营养指数。通过间接量热法测定稀土元素，通过双能 X 射线吸收法 (DXA)、生物电阻抗分析和皮褶厚度分析测定身体成分。激素指标包括瘦素、睾酮、雌二醇和胰岛素样生长因子 I。 结果：HIV 感染者的 REE 高于对照者 [6794 +/- 1374 与 6011 +/- 607 kJ/d 相比（1624 +/- 329 与 1437 +/- 145 kcal/d 相比），P = 0.0096]。平均而言，HIV 感染者的 REE 为 Harris-Benedict 预测的 119 +/- 23%，而对照组为 102 +/- 9%（P = 0.0007）。在 HIV 感染者中，REE 与 DXA 测定的无脂体重 (FFM) 高度相关（R = 0.641，P < 0.001），但与体重或疾病状态无关。 HIV 感染受试者 [REE (kJ/d) = 203.5 (kg FFM) - 1237] 的 REE 和 FFM 回归方程的斜率显着大于对照受试者 [REE (kJ/d) = 77.4 (kg FFM) + 2923]（P = 0.027，协方差分析）。在逐步回归分析中，FFM 是最显着的变量 (P = 0.005)，其次是游离睾酮 (P = 0.029)，它们共同解释了 REE 变异的 4946 个。最终方程为 REE (kJ/d)= 230.8 (kg FFM) + 395.9（游离睾酮，pmol/L）- 3304。结论：HIV 感染女性的能量消耗高于对照女性。 FFM 是 HIV 感染女性 REE 的主要决定因素，但 HIV 感染者每公斤 FFM 的能量消耗高于对照组，这可能导致消耗综合症。
Background: Little is known about sex-specific effects of HIV infection on energy expenditure.Objective: We investigated the determinants of energy expenditure in HIV-infected women.Design: Resting energy expenditure (REE), body composition, and hormonal and nutritional indexes were compared in 33 ambulatory, premenopausal HIV-infected women and 26 weight-matched, healthy premenopausal control subjects. REE was determined by indirect calorimetry and body composition by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis, and skinfold-thickness analysis. Hormonal indexes included leptin, testosterone, estradiol, and insulin-like growth factor I.Results: HIV-infected subjects had a higher REE than control subjects [6794 +/- 1374 compared with 6011 +/- 607 kJ/d (1624 +/- 329 compared with 1437 +/- 145 kcal/d), P = 0.0096]. On average, REE was 119 +/- 23% of Harris-Benedict predictions in HIV-infected subjects compared with 102 +/- 9% for control subjects (P = 0.0007). In HIV-infected subjects, REE was highly correlated with fat-free mass (FFM) by DXA (R = 0.641, P < 0.001), but not with weight or disease status. The slope of the regression equation for REE and FFM was significantly greater (P = 0.027, analysis of covariance) for HIV-infected subjects [REE (kJ/d) = 203.5 (kg FFM) - 1237] than for control subjects [REE (kJ/d) = 77.4 (kg FFM) + 2923]. In a stepwise regression analysis, FFM was the most significant variable (P = 0.005), followed by free testosterone (P = 0.029), which together explained 4946 of the variation in REE. The final equation was REE (kJ/d)= 230.8 (kg FFM) + 395.9 (free testosterone, pmol/L) - 3304.Conclusions: Energy expenditure was higher in HIV-infected women than in control women. FFM is the primary determinant of REE in HIV-infected women, but energy expenditure is greater per kg FFM in HIV-infected subjects than in control subjects, which may contribute to the wasting syndrome.