Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi
Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi
复制标题
DOI：
10.1186/1471-2334-4-61
复制
发表时间：
2004-12-21
影响因子：
3.7
通讯作者：
Semba, RD
中科院分区：
文献类型：
--
作者：
van Lettow, M;Harries, AD;Semba, RD
背景：成人肺结核患者的消瘦和微量营养素营养不良尚未被很好地表征。我们假设微量营养素营养不良与成人肺结核患者的消瘦和较高的血浆人类免疫缺陷病毒（HIV）载量有关。方法：在马拉维Zomba的一项横断面研究中，对579名HIV阳性和222名HIV阴性的肺结核成人进行了人体测量、血浆HIV载量和血浆微量营养素浓度（视黄醇、α -生育酚、类胡萝卜素、锌和硒）的测量。在不同的消瘦严重程度下，研究了微量营养素缺乏的风险。结果：体重指数（BMI）、血浆视黄醇、类胡萝卜素和硒浓度随HIV病毒载量的增加而显著降低。血浆微量营养素浓度在HIV阴性个体和HIV阳性个体之间无显著差异。血浆维生素A < 0.70 μ mol/L的发生率为61%，锌和硒缺乏的发生率分别为85%和87%。消瘦（定义为BMI< 18.5）在59%的研究参与者中存在，并且与类胡萝卜素含量低、维生素a和硒缺乏的较高风险独立相关。重度消瘦（BMI< 16.0）与维生素A、硒和血浆类胡萝卜素缺乏的关系最为密切。结论：这些数据表明，肺结核患者的消瘦和较高的艾滋病毒载量与微量营养素营养不良有关。
Background: Wasting and micronutrient malnutrition have not been well characterized in adults with pulmonary tuberculosis. We hypothesized that micronutrient malnutrition is associated with wasting and higher plasma human immunodeficiency virus (HIV) load in adults with pulmonary tuberculosis.Methods: In a cross-sectional study involving 579 HIV-positive and 222 HIV-negative adults with pulmonary tuberculosis in Zomba, Malawi, anthropometry, plasma HIV load and plasma micronutrient concentrations ( retinol, alpha- tocopherol, carotenoids, zinc, and selenium) were measured. The risk of micronutrient deficiencies was examined at different severity levels of wasting.Results: Body mass index (BMI), plasma retinol, carotenoid and selenium concentrations significantly decreased by increasing tertile of plasma HIV load. There were no significant differences in plasma micronutrient concentrations between HIV-negative individuals and HIV-positive individuals who were in the lowest tertile of plasma HIV load. Plasma vitamin A concentrations < 0.70 mu mol/L occurred in 61%, and zinc and selenium deficiency occurred in 85% and 87% respectively. Wasting, defined as BMI< 18.5 was present in 59% of study participants and was independently associated with a higher risk of low carotenoids, and vitamin A and selenium deficiency. Severe wasting, defined as BMI< 16.0 showed the strongest associations with deficiencies in vitamin A, selenium and plasma carotenoids.Conclusions: These data demonstrate that wasting and higher HIV load in pulmonary tuberculosis are associated with micronutrient malnutrition.