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

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 艾滋病毒感染者消瘦的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将增加体重和瘦肉组织，先前无意体重减轻> 3%。59名HIV RNA浓度<5000拷贝/mL的受试者被随机分配接受含40 g乳清蛋白的280 kcal补充剂或不添加蛋白质的匹配等热量对照补充剂，每日两次，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的需求量（分别为44.3 <$12.6千卡/千克/天和1.69 <$0.55克/千克/天）。两种补充剂都未能增加总能量摄入，因为自选食物摄入量减少。乳清蛋白组和对照组的体重变化（0.8 <$2.4和0.7 <$2.4 kg）和瘦体重变化（0.3 <$1.4和0.3 <$1.5 kg）分别无显著差异。在第6周时，乳清蛋白组的腰臀比（-0.02 <$0.05）比对照组（0.01 <$0.03; P=0.025）改善更多，但在第12周时没有改善。在第12周，对照补充剂的空腹三酰甘油增加了39 <$98 mg/dL，乳清蛋白降低了16 <$62 mg/dL（P=0.03）。在12周时，乳清蛋白使CD 4淋巴细胞增加31 <$84个/mm 3，而对照补充剂使其减少5 <$124个/mm 3（P=0.03）。胃肠道症状更常发生乳清蛋白。

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.