Grinspoon SK; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 552 (abstract no. 337/32162).
Neuroendo Crine-Mass. General Hospital, Boston 02114-2696, USA.
BACKGROUND: Although increased resting energy expenditure (REE) in association with decreased caloric intake has been reported in men with AIDS, little is known regarding gender-specific effects of HIV-infection on energy expenditure in women. OBJECTIVE: To determine REE in HIV infected women. METHODS: REE was measured by indirect calorimetry in 33 ambulatory, clinically stable, premenopausal HIV-infected women in whom body composition, hormonal and nutritional parameters were characterized. RESULTS: HIV-infected patients had a higher REE than weight-matched premenopausal controls [6794 +/- 1374 vs. 6011 +/- 607 Kjoule/day (1624 +/- 329 vs. 1437 +/- 145 Kcal/day), P = 0.0096]. On average, REE was 119 +/- 23% of predicted by the Harris-Benedict equation among the HIV-infected patients compared to 102 +/- 9% for the controls (P = 0.0007). Among the HIV-infected patients, REE was highly correlated with fat-free mass [FFM, determined by dual energy X-ray absorptiometry (DEXA)] (R = 0.641, P < 0.001) but did not correlate with weight or disease status, determined by either CD4 count or Chiron DNA analysis. The slope of the regression equation for REE and FFM was significantly greater for the HIV-infected [REE (Kjoule) = 203.5 (kg FFM) -1237] patients than the control subjects [REE (Kjoule) = 77.4 (kg FFM) + 2923], (P = 0.027 for comparison of slopes by ANCOVA). In a forward selection stepwise regression analysis, including terms for body composition, hormonal and nutritional parameters, REE was most significantly associated with FFM (P = 0.005) and also with serum free testosterone (P = 0.029) which together explained 49% of the variation in REE. The final equation was, REE (Kjoule) = 230.8 (kg FFM) + 1372.6 (free testosterone)-3304. CONCLUSIONS: These data are the first to demonstrate increased energy expenditure in ambulatory HIV-infected women and suggest a steeper increase in REE with higher FFM in HIV-infected compared to control subjects which may contribute to the wasting syndrome. Further studies are needed to determine the underlying gender-specific and/or hormonal factors which contribute to increased REE in HIV-infected women.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Body Composition
- Body Weight
- CD4 Lymphocyte Count
- Calorimetry, Indirect
- Case-Control Studies
- Energy Intake
- Energy Metabolism
- Female
- HIV Infections
- HIV Seropositivity
- Health Expenditures
- Humans
- Male
- Nutritional Status
- Regression Analysis
- Rest
- economics
Other ID:
UI: 102229677
From Meeting Abstracts