EVALUATION OF HIGH-PROTEIN SUPPLEMENTATION IN WEIGHT-STABLE HIV-POSITIVE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 消瘦的艾滋病毒患者机会性并发症和死亡的风险增加。我们假设，在体重稳定的受试者中，增加高生物价值蛋白质的饮食摄入量会增加体重和瘦肉组织，且先前的无意体重下降了3%。59名HIV RNA浓度为5000拷贝/毫升的受试者被随机分配到280千卡的补充剂中，其中乳清蛋白40克，或与之匹配的等卡路里对照补充剂，不添加蛋白质，每天两次，持续12周。在研究之前，总能量和蛋白质的摄入量超过了估计需要量(分别为44.3±12.6千卡/公斤/天和1.69±0.55克/公斤/天)。由于自选食物摄入量减少，两种补充剂都未能增加总能量摄入量。体重(0.8±2.4和0.7±2.4千克)和瘦体质量(0.3±1.4和0.3±1.5千克)的变化在乳清蛋白组和对照组之间没有显著差异。6周时添加乳清蛋白组的腰臀比(-0.02±0.05)显著高于对照组(0.01±0.03；P=0.025)，12周时空腹三酰甘油增加39±98 mg/dL，添加乳清蛋白组降低16±62 mg/dL(P=0.03)。添加乳清蛋白12周时，添加乳清蛋白的仔猪外周血中CD_4细胞数增加31±84个/mm~3，对照组减少5±124个/mm~3(P=0.03)。使用乳清蛋白更容易出现胃肠道症状。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. HIV patients with wasting are at increased risk of opportunistic complications and fatality. We hypothesized that augmenting dietary intake with high-biologic-value protein would enhance weight and lean tissue in weight-stable subjects with a prior unintentional weight loss of >3%. Fifty-nine subjects with HIV RNA concentrations <5000 copies/mL were randomly assigned to receive a 280-kcal supplement containing 40 g whey protein or a matched isocaloric control supplement without added protein twice daily for 12 wk. Before the study, intake of total energy and protein exceeded estimated requirements (44.3 ¿ 12.6 kcal/kg/d and 1.69 ¿ 0.55 g/kg/d, respectively). Both supplements failed to increase total energy intake because of decreases in self-selected food intake. Changes in weight (0.8 ¿ 2.4 and 0.7 ¿ 2.4 kg) and lean body mass (0.3 ¿ 1.4 and 0.3 ¿ 1.5 kg) did not differ significantly between the whey protein and control groups, respectively. Waist-to-hip ratio improved more with whey protein (-0.02 ¿ 0.05) than in control (0.01 ¿ 0.03; P=0.025) at week 6 but not at week 12. Fasting triacylglycerol increased by 39 ¿ 98 mg/dL with the control supplement and decreased by 16 ¿ 62 mg/dL with whey protein at week 12 (P=0.03). CD4 lymphocytes increased by 31 ¿ 84 cells/mm3 with whey protein and decreased by 5 ¿ 124 cells/mm3 with the control supplement at 12 wk (P=0.03). Gastrointestinal symptoms occurred more often with whey protein.