High resting energy expenditure, less fat-free mass, and less muscle strength in HIV-infected children: a matched, cross-sectional study

Frontiers in Nutrition

Nutrition

Javier Ordoñez-Ortega¹  Ana Laura Pardo-Gutiérrez²  Andrea Franco-Oliva³  Isabel Medina-Vera⁴  Ximena León-Lara⁵  Martha C. Martínez-Soto-Holguín⁶  Beatriz Adriana Pinzón-Navarro⁷  Martha Guevara-Cruz⁸  Alda Daniela García-Guzmán⁹  Azalia Avila-Nava^1,10  Laura Guevara-Pedraza^1,11 

[1] Departamento de Infectología Pediátrica, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Maestría en Nutrición Clínica, Escuela de Dietética y Nutrición del ISSSTE, Ciudad de México, México;Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México, Mexico;Institute of Immunology, Hannover Medical School, Hannover, Germany;Servicio de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Servicio de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México, Mexico;Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México, Mexico;Departamento de Fisiología de la Nutrición, Instituto Nacional de Nutrición y Ciencias Médicas Salvador Zubirán, Ciudad de México, Mexico;Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México, Mexico;Servicio de Oncología Médica, Instituto Nacional de Pediatría, Ciudad de México, Mexico;Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, Mexico;Universidad Anahuac, Ciudad de México, Mexico;

关键词: HIV-infected;    children;    adolescents;    resting energy expenditure;    fat free mass;    handgrip strength;   

DOI  :  10.3389/fnut.2023.1220013

 received in 2023-05-09, accepted in 2023-08-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background and aimsMany improvements have been made in the treatment of human immunodeficiency virus (HIV) in pediatric patients; however, challenges remain in terms of achieving normal growth, body composition, and metabolism during treatment, etc. Current nutritional recommendations are based on studies performed in adults, with limited data on the HIV-infected pediatric population. Therefore, this study aimed to compare the resting energy expenditure (REE) of asymptomatic HIV-infected pediatric patients with healthy counterparts and to compare body composition, dietary intake, and physical activity between the two groups.MethodsThis was a cross-sectional study of asymptomatic HIV-infected children who were receiving antiretroviral therapy; the infected group was compared with the uninfected group, matched by age (± 6 months), sex, and body mass index (± 0.5 z-score). Participants were recruited between 2021 and 2022, as outpatients. In both groups, REE was determined by indirect calorimetry and body composition by bioelectrical impedance analysis and hand strength, measured using a hydraulic hand dynamometer.ResultsSeventy-eight participants were enrolled, where n = 39 HIV-infected children and n = 39 controls, with a mean age of 11.6 ± 3.4 years old. REE was significantly higher in the HIV group (1254.4 ± 334.7 kcal/day vs. 1124.7 ± 321 kcal/day, p = 0.013) than in the control group. Fat-free mass (FFM) was lower in the HIV group (28.2 ± 10.5 kg vs. 32 ± 11.2 kg, p = 0.001); this trend continued when the index skeletal muscle was evaluated (7.2 ± 1.2 vs. 7.6 ± 1.5, p = 0.04). The strength of the dominant hand was also lower in the HIV group (12 (8–18) kg vs. 20 (10.5–26) kg, p < 0.0001).ConclusionsChildren with asymptomatic HIV infection have higher REE than their uninfected peers. They also present decreased FFM, skeletal muscle mass index, and muscle strength. These parameters should be considered during nutritional assessment in this population to have a favorable impact on nutritional status and growth.

【 授权许可】

Unknown   
Copyright © 2023 Franco-Oliva, Pinzón-Navarro, Martínez-Soto-Holguín, León-Lara, Ordoñez-Ortega, Pardo-Gutiérrez, Guevara-Cruz, Avila-Nava, García-Guzmán, Guevara-Pedraza and Medina-Vera.