期刊论文详细信息
BMC Infectious Diseases
Distinct gender differences in anthropometric profiles of a peri-urban South African HIV population: a cross sectional study
M Faadiel Essop3  Rehana Essop4  Esme Calitz2  Dillan C Beukes3  Maritza J Kruger3  Theodore A Nell1 
[1] Division of Community Health, Tygerberg Campus, Stellenbosch 7600, South Africa;TC Newman Community Day Care Centre, Paarl 7646, South Africa;Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Stellenbosch University, Mike De Vries Building, Merriman Avenue, Stellenbosch 7600, South Africa;ANOVA Health Institute, Kohler Street, Paarl 7646, South Africa
关键词: South Africa;    Peri-urban;    HAART;    Body composition;    Anthropometry;    HIV;   
Others  :  1132599
DOI  :  10.1186/s12879-015-0836-9
 received in 2014-08-19, accepted in 2015-02-13,  发布年份 2015
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【 摘 要 】

Background

Highly active antiretroviral therapy (HAART) has extended life expectancy and enhanced the well-being of HIV-positive individuals. Since there are concerns regarding HAART-mediated onset of cardio-metabolic diseases in the long-term, we evaluated the anthropometric profile of black HIV-infected individuals in a peri-urban setting (Western Cape, South Africa).

Methods

A cross sectional study design was followed to describe the gender differences in different HAART treatment groups. HIV-positive patients (n = 44 males, n = 102 females; 20–40 years) were recruited for three groups: 1) control (HIV-positive, HAART-naïve), 2) HIV-positive (<3 years HAART), and 3) HIV-positive (>3 years HAART).

Results

All participants underwent comprehensive anthropometric and bio-electrical impedance analyses. No significant differences were observed in the male treatment groups. HAART-naïve females are mostly overweight (73.90 ± 2.79). This is followed by a period of muscle wasting seen in the triceps skinfold (29.30 ± 2.19 vs 20.63 ± 1.83; p < 0.01), muscle mass (22.23 ± 0.46 vs 19.82 ± 0.54; p < 0.01), and fat free mass (49.40 ± 1.08 vs 44.16 ± 1.21; p < 0.01) upon HAART initiation (<3 years HAART). Thereafter all parameters measured had levels similar to that seen for the female HAART-naïve group. Females on <3 years HAART exhibited significantly decreased body cell mass (p < 0.01), protein mass (p < 0.01), muscle mass (p < 0.01), fat free mass (p < 0.01), and fat mass (p < 0.001) versus matched HAART-naïve controls. The W:H ratio for the female treatment groups placed the females overall at a higher risk for developing cardiovascular disease compared to the males.

Conclusions

This study found striking gender-based anthropometric differences in black South African HIV-positive individuals on HAART. We also conclude from this observational study that no significant differences were found in the different male treatment groups. All female body composition parameters initially showed lower values (<3 years HAART). The female treatment group (>3 years HAART) displayed values similar to that seen in the HAART-naïve group. Higher W:H ratios in females receiving longer-term HAART potentially increases their risk for the future onset of cardio-metabolic complications.

【 授权许可】

   
2015 Nell et al.; licensee BioMed Central.

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【 参考文献 】
  • [1]Department of Health of the Republic of South Africa. Revised anti-retroviral treatment guideline update for frontline clinical health professionals. [http://www.sahivsoc.org/upload/documents/FDC%20Training%20Manual%2014%20March%202013(1).pdf]
  • [2]Bor J, Herbst AJ, Newell M-L, Bärnighausen T: Increases in adult life expectancy in rural South Africa: Valuing the scale-up of HIV treatment. Science 2013, 339:961-5.
  • [3]Boccara F, Lang S, Meuleman C, Ederhy S, Mary-Krause M, Costagliola D, et al.: HIV and coronary heart disease: time for a better understanding. J Am Coll Cardiol 2013, 61:511-23.
  • [4]Stein JH, Hadigan CM, Brown TT, Chadwick E, Feinberg J, Friis-Moller N, et al.: Prevention strategies for cardiovascular disease in HIV-infected patients. Circ 2008, 118:e54-60.
  • [5]Currier JS, Stein JH: HIV and atherosclerosis: Moving from associations to mechanisms and interventions (Editorial). Ann Intern Med 2014, 160:509-10.
  • [6]Duprez DA, Neuhaus J, Kuller LH, Tracy R, Belloso W, De Wit S, et al.: Inflammation, coagulation and cardiovascular disease in HIV-infected individuals. PLoS One 2012, 7:e44454.
  • [7]Arsenault BJ, Lemieux I, Despres JP, Wareham NJ, Kastelein JJ, Khaw KT, et al.: The hypertriglyceridemic-waist phenotype and the risk of cornonary artery disease: Results from the EPIC-Norfolk prospective population study. CMAJ 2010, 182:1427-32.
  • [8]De Graaf FR, Schuijf DJ, Scholte AJ, Djaberi R, van Velzen JE, Roos CJ, et al.: Usefulness of hypertriglyceridemic waist phenotype in type 2 diabetes mellitus to predict the presence of coronary artery disease as assessed by computed tomographic coronary angiography. Am J Cardiol 2010, 106:1747-53.
  • [9]Grunfeld C, Saag M, Cofrancesco JJ, Lewis CE, Kronmal R, Heymsfield S, et al.: Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indicates persistence of HIV-associated lipoatrophy. AIDS 2010, 24:1717-26.
  • [10]Mutimura E, Stewart A, Rheeder P, Crowther NJ: Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2007, 46:451-5.
  • [11]Eleje GU, Ele PU, Okocha EC, Iloduba UC: Epidemiology and clinical parameters of adult human immunodeficiency virus/acquired immunodeficiency syndrome at the initiation of antiretroviral therapy in South Eastern Nigeria. Ann Med Health Sci Res 2014, 4:217-21.
  • [12]Goedecke JH, Micklesfield LK, Levitt NS, Lambert EV, West S, Maartens G, et al.: Effect of different antiretroviral drug regimens on body fat distribution of HIV-infected South African women. AIDS Res Hum Retroviruses 2013, 29:557-63.
  • [13]Wasserman P, Segal-Maurer S, Rubin DS: High prevalence of low skeletal muscle mass associated with male gender in midlife and older HIV-infected persons despite CD4 cell reconstitution and viral suppression. J Int Assoc Provid AIDS Care 2014, 13:145-52.
  • [14]van Griensven J, Lynen L, Colebunders R: Substituting tenofovir for stravudine in resource-limited settings: there are challenges ahead (correspondence). AIDS 2009, 23:1027-33.
  • [15]Stewart A, Marfell-Jones M, Olds T, de Ridder H: International standards for anthropometric assessment. ISAK: International Society for the Advancement of Kinanthropometry. 2011.
  • [16]Goedecke JH, Jennings CL, Lambert EV: Obesity in South Africa. In Chronic Diseases of Lifestyle in South Africa: 1995–2005. Edited by Steyn K, Fourie J, Temple N. South African Medical Research Council, Cape Town; 2006:65-79.
  • [17]Kruger H, Puoane T, Senekal M, van der Merwe M: Obesity in South Africa: challenges for government and health professionals. Public Health Nutr 2005, 8:491-500.
  • [18]Hurley E, Coutsoudis A, Giddy J, Knight SE, Loots E, Esterhuizen TM: Weight evolution and perceptions of adults living with HIV following initiation of antiretroviral therapy in a South African urban setting. S Afr Med J 2011, 101:645-50.
  • [19]Padmapriyadarsini C, Swaminathan S, Karthipriya MJ, Narendran G, Menon PA, Thomas BE: Morphologic and body composition changes are different in men and women on generic combination antiretroviral therapy-an observational study. J Assoc Physicians India 2010, 58:375-7.
  • [20]George JA, Venter WD, Van Deventer HE, Crowther NJ: A longitudinal study of the changes in body fat and metabolic parameters in a South African population of HIV-positive patients receiving an antiretroviral therapeutic regimen containing stavudine. AIDS Res Hum Retroviruses 2009, 25:771-81.
  • [21]van Griensven J, De Naeyer L, Mushi T, Ubarijoro S, Gashumba D, Gazille C, et al.: High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda. Trans R Soc Trop Med Hyg 2007, 101:793-8.
  • [22]Chang E, Sekhar R, Patel S, Balasubramanyam A: Dysregulated energy expenditure in HIV-infected patients: a mechanistic review. Clin Infect Dis 2007, 44:1509-17.
  • [23]Willig AL, Overton ET: Metabolic consequences of HIV: pathogenic insights. Curr HIV/AIDS Rep 2014, 11:35-44.
  • [24]Sicotte M, Ledoux M, Zunzunegui MV, Ag Aboubacrine S, Nguyen VK: Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa. BMC Med Res Methodol 2010, 10:102.
  • [25]Swaminathan S, Padmapriyadarsini C, Sukumar B, Iliayas S, Kumar SR, Triveni C, et al.: Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India. Clin Infect Dis 2008, 46:946-9.
  • [26]Schwandt P, Bertsch T, Haas GM: Anthropometric screening for silent cardiovascular risk factors in adolescents: the PEP Family Heart Study. Atherosclerosis 2010, 211:667-71.
  • [27]Weber DR, Levitt Katz LE, Zemel BS, Gallagher PR, Murphy KM, Dumser SM, et al.: Anthropometric measures of abdominal adiposity for the identification of cardiometabolic risk factors in adolescents. Diabetes Res Clin Pract 2014, 103:e14-7.
  • [28]WHO Expert Consultation. Waist Circumference and Waist-Hip Ratio (Report). [http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf]
  • [29]Rasheed S, Yan JS, Lau A, Chan AS: HIV replication enhances production of free fatty acids, low density lipoproteins and many key proteins involved in lipid metabolism: a proteonomics study. PLoS One 2008, 3:1-15.
  • [30]Deng T, Lyon CJ, Minze LJ, Lin J, Zou J, Liu JZ, et al.: Class II major histocompatibility complex plays an essential role in obesity-induced adipose inflammation. Cell Metab 2013, 17:411-22.
  • [31]Connolly C, Colvin M, Shisana O, Stoker D: Epidemiology of HIV in South Africa-results of a national, community-based survey. S Afr Med J 2008, 94:776.
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