Wasting Among Uganda Men with Pulmonary Tuberculosis is Associated with Linear Regain in Lean Tissue Mass During and After Treatment in Contrast to Women with Wasting Who Regain Fat Tissue Mass: Prospective Cohort Study

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2014 Jan 14

PMID 24410970

Citations 13

Authors

Ezekiel Mupere

LaShaunda Malone

Sarah Zalwango

Alphonse Okwera

Mary Nsereko

Daniel J Tisch

Isabel M Parraga

Catherine M Stein

Roy Mugerwa

W Henry Boom

Harriet K Mayanja

Christopher C Whalen

Affiliations

Soon will be listed here.

Abstract

Background: Nutritional changes during and after tuberculosis treatment have not been well described. We therefore determined the effect of wasting on rate of mean change in lean tissue and fat mass as measured by bioelectrical impedance analysis (BIA), and mean change in body mass index (BMI) during and after tuberculosis treatment.

Methods: In a prospective cohort study of 717 adult patients, BMI and height-normalized indices of lean tissue (LMI) and fat mass (FMI) as measured by BIA were assessed at baseline, 3, 12, and 24 months.

Results: Men with wasting at baseline regained LMI at a greater rate than FMI (4.55 kg/m2 (95% confidence interval (CI): 1.26, 7.83 versus 3.16 (95% CI: 0.80, 5.52)) per month, respectively during initial tuberculosis therapy. In contrast, women with wasting regained FMI at greater rate than LMI (3.55 kg/m2 (95% CI: 0.40, 6.70) versus 2.07 (95% CI: -0.74, 4.88)), respectively. Men with wasting regained BMI at a rate of 6.45 kg/m2 (95% CI: 3.02, 9.87) in the first three months whereas women, had a rate of 3.30 kg/m2 (95% CI: -0.11, 6.72). There were minimal changes in body composition after month 3 and during months 12 to 24.

Conclusion: Wasted tuberculosis patients regain weight with treatment but the type of gain differs by gender and patients may remain underweight after the initial phase of treatment.

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References

Zurlo F, Lillioja S, Esposito-Del Puente A, Nyomba B, Raz I, Saad M . Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ. Am J Physiol. 1990; 259(5 Pt 1):E650-7. DOI: 10.1152/ajpendo.1990.259.5.E650. View

Tomkins A, Garlick P, Schofield W, WATERLOW J . The combined effects of infection and malnutrition on protein metabolism in children. Clin Sci (Lond). 1983; 65(3):313-24. DOI: 10.1042/cs0650313. View

Harries A, Nkhoma W, Thompson P, Nyangulu D, Wirima J . Nutritional status in Malawian patients with pulmonary tuberculosis and response to chemotherapy. Eur J Clin Nutr. 1988; 42(5):445-50. View

Stein C, Nshuti L, Chiunda A, Boom W, Elston R, Mugerwa R . Evidence for a major gene influence on tumor necrosis factor-alpha expression in tuberculosis: path and segregation analysis. Hum Hered. 2005; 60(2):109-18. DOI: 10.1159/000088913. View

Paton N, Castello-Branco L, Jennings G, Elia M, Costa S, Griffin G . Impact of tuberculosis on the body composition of HIV-infected men in Brazil. J Acquir Immune Defic Syndr Hum Retrovirol. 1999; 20(3):265-71. DOI: 10.1097/00042560-199903010-00008. View

FERRO-LUZZI A, Petracchi C, Kuriyan R, Kurpad A . Basal metabolism of weight-stable chronically undernourished men and women: lack of metabolic adaptation and ethnic differences. Am J Clin Nutr. 1997; 66(5):1086-93. DOI: 10.1093/ajcn/66.5.1086. View

van Lettow M, Kumwenda J, Harries A, Whalen C, Taha T, Kumwenda N . Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis. 2004; 8(2):211-7. View

Oberg A, Mahoney D . Linear mixed effects models. Methods Mol Biol. 2008; 404:213-34. DOI: 10.1007/978-1-59745-530-5_11. View

Nagy T, Goran M, Weinsier R, Toth M, Schutz Y, Poehlman E . Determinants of basal fat oxidation in healthy Caucasians. J Appl Physiol (1985). 1996; 80(5):1743-8. DOI: 10.1152/jappl.1996.80.5.1743. View

10.

Schutz Y, Kyle U, Pichard C . Fat-free mass index and fat mass index percentiles in Caucasians aged 18-98 y. Int J Obes Relat Metab Disord. 2002; 26(7):953-60. DOI: 10.1038/sj.ijo.0802037. View

11.

Mayanja-Kizza H, Jones-Lopez E, Okwera A, Wallis R, Ellner J, Mugerwa R . Immunoadjuvant prednisolone therapy for HIV-associated tuberculosis: a phase 2 clinical trial in Uganda. J Infect Dis. 2005; 191(6):856-65. PMC: 4515766. DOI: 10.1086/427995. View

12.

Casazza K, Hanks L, Beasley T, Fernandez J . Beyond thriftiness: independent and interactive effects of genetic and dietary factors on variations in fat deposition and distribution across populations. Am J Phys Anthropol. 2011; 145(2):181-91. PMC: 3099307. DOI: 10.1002/ajpa.21483. View

13.

Paton N, Ng Y . Body composition studies in patients with wasting associated with tuberculosis. Nutrition. 2006; 22(3):245-51. DOI: 10.1016/j.nut.2005.06.009. View

14.

Macallan D . Malnutrition in tuberculosis. Diagn Microbiol Infect Dis. 1999; 34(2):153-7. DOI: 10.1016/s0732-8893(99)00007-3. View

15.

Mooradian A, Morley J, Korenman S . Biological actions of androgens. Endocr Rev. 1987; 8(1):1-28. DOI: 10.1210/edrv-8-1-1. View

16.

Mostert R, Goris A, Weling-Scheepers C, Wouters E, Schols A . Tissue depletion and health related quality of life in patients with chronic obstructive pulmonary disease. Respir Med. 2000; 94(9):859-67. DOI: 10.1053/rmed.2000.0829. View

17.

van Lettow M, Fawzi W, Semba R . Triple trouble: the role of malnutrition in tuberculosis and human immunodeficiency virus co-infection. Nutr Rev. 2003; 61(3):81-90. DOI: 10.1301/nr.2003.marr.81-90. View

18.

Niyongabo T, Henzel D, Idi M, Nimubona S, Gikoro E, Melchior J . Tuberculosis, human immunodeficiency virus infection, and malnutrition in Burundi. Nutrition. 1999; 15(4):289-93. DOI: 10.1016/s0899-9007(99)00003-9. View

19.

Whalen C, Zalwango S, Chiunda A, Malone L, Eisenach K, Joloba M . Secondary attack rate of tuberculosis in urban households in Kampala, Uganda. PLoS One. 2011; 6(2):e16137. PMC: 3038854. DOI: 10.1371/journal.pone.0016137. View

20.

Mupere E, Zalwango S, Chiunda A, Okwera A, Mugerwa R, Whalen C . Body composition among HIV-seropositive and HIV-seronegative adult patients with pulmonary tuberculosis in Uganda. Ann Epidemiol. 2010; 20(3):210-6. PMC: 2824615. DOI: 10.1016/j.annepidem.2009.11.001. View