An optimal BMI range associated with a lower risk of mortality among HIV-infected adults initiating antiretroviral therapy in Guangxi, China
An optimal BMI range associated with a lower risk of mortality among HIV-infected adults initiating antiretroviral therapy in Guangxi, China
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中国广西开始抗逆转录病毒治疗的艾滋病毒感染者的最佳体重指数范围与较低的死亡风险相关
DOI：
10.1038/s41598-019-44279-z
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发表时间：
2019-05-24
影响因子：
4.6
通讯作者：
Ye, Li
中科院分区：
文献类型：
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作者：
Jiang, Junjun;Qin, Xionglin;Ye, Li
以前对艾滋病病毒感染者的研究表明，体重不足与艾滋病死亡率之间存在直接联系。然而，缺乏证据表明患者在抗逆转录病毒治疗（ART）期间维持初始体重指数（BMI）的最佳范围。我们的目的是评估BMI值在ART前和整个ART期间与HIV阳性个体死亡率的相关性。共纳入5101例HIV/AIDS患者，包括1439例（28.2%）体重不足、3047例（59.7%）正常体重、548例（10.7%）超重和67例（1.3%）肥胖患者。体重不足、正常体重和超重的累积死亡率分别为2.4/100人-年（95%CI 1.9 -2.9）、1.1/100人-年（95%CI 0.9 -1.3）和0.5/100人-年（95%CI 0.1 -0.9）。体重正常和超重人群的累积死亡率均低于体重不足人群，校正后的风险比（AHR）分别为0.5（95%CI0.4- 0.7，p < 0.001）和0.3（95%CI0.1- 0.6，p = 0.002）。此外，在1176例有可用病毒载量数据的患者中，在调整所有因素（包括病毒载量）后，体重不足组和体重正常组之间存在显著差异（p= 0.031）。这一结果表明，广西HIV感染者BMI保持在19-28 kg/m2，特别是24-28 kg/m2，死亡风险降低。
Previous studies investigating HIV-infected patients suggested a direct link between underweight and the mortality rate of AIDS. However, there was a lack of evidence showing the optimal range of initial body mass index (BMI) patients maintain during antiretroviral therapy (ART). We aimed to evaluate associations of the BMI values pre-ART and during the entire ART duration with mortality among HIV-positive individuals. In total, 5101 HIV/AIDS patients, including 1439 (28.2%) underweight, 3047 (59.7%) normal-weight, 548 (10.7%) overweight and 67 (1.3%) obese patients, were included in this cohort. The cumulative mortality of underweight, normal-weight, and overweight were 2.4/100 person-years (95%CI1.9–2.9), 1.1/100 person-years (95%CI0.9–1.3), and 0.5/100 person-years (95%CI0.1–0.9), respectively. Cumulative mortality was lower in both the normal-weight and overweight populations than in the underweight population, with an adjusted hazard ratio (AHR) of 0.5 (95%CI0.4–0.7,p< 0.001) and 0.3 (95%CI0.1–0.6,p= 0.002), respectively. Additionally, in the 1176 patients with available viral load data, there was significant difference between the underweight and normal-weight groups after adjustment for all factors, including viral load (p= 0.031). This result suggests that HIV-infected patients in Guangxi maintaining a BMI of 19–28 kg/m2, especially 24–28 kg/m2, have a reduced risk of death.