Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study

作者：Jacobson Denise L^*; Patel Kunjal; Siberry George K; Van Dyke Russell B; DiMeglio Linda A; Geffner Mitchell E; Chen Janet S; McFarland Elizabeth J; Borkowsky William; Silio Margarita; Fielding Roger A; Siminski Suzanne; Miller Tracie L

来源：American Journal of Clinical Nutrition, 2011, 94(6): 1485-1495.

DOI：10.3945/ajcn.111.020271

Background: Associations between abnormal body fat distribution and clinical variables are poorly understood in pediatric HIV disease.
Objective: Our objective was to compare total body fat and its distribution in perinatally HIV-infected and HIV-exposed but un-infected (HEU) children and to evaluate associations with clinical variables.
Design: In a cross-sectional analysis, children aged 7-16 y in the Pediatric HIV/AIDS Cohort Study underwent regionalized measurements of body fat via anthropometric methods and dual-energy X-ray absorptiometry. Multiple linear regression was used to evaluate body fat by HIV, with adjustment for age, Tanner stage, race, sex, and correlates of body fat in HIV-infected children. Percentage total body fat was compared with NHANES data.
Results: Males accounted for 47% of the 369 HIV-infected and 51% of the 176 HEU children. Compared with HEU children, HIV-infected children were older, were more frequently non-Hispanic black, more frequently had Tanner stage >= 3, and had lower mean height (-0.32 compared with 0.29), weight (0.13 compared with 0.70), and BMI (0.33 compared with 0.63) z scores. On average, HIV-infected children had a 5% lower percentage total body fat (TotF), a 2.8% lower percentage extremity fat (EF), a 1.4% higher percentage trunk fat (TF), and a 10% higher trunk-to- extremity fat ratio (TEFR) than did the HEU children and a lower TotF compared with NHANES data. Stavudine use was associated with lower EF and higher TF and TEFR. Non-nucleotide reverse transcriptase inhibitor use was associated with higher TotF and EF and lower TEFR.
Conclusion: Although BMI and total body fat were significantly lower in the HIV-infected children than in the HEU children, body fat distribution in the HIV-infected children followed a pattern associated with cardiovascular disease risk and possibly related to specific antiretroviral drugs. Am J Clin Nutr 2011; 94: 1485-95.

• 出版日期2011-12