1 Paediatric and International Nutrition, Department of Nutrition, Exercise and Sports, Faculty of Science, Københavns Universitet2 Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, Københavns Universitet3 Mwanza Research Centre, National Institute of Medical Research, Tanzania.4 Paediatric Nutrition and International Nutrition, Department of Human Nutrition, Faculty of Life Sciences, Københavns Universitet5 Clinical Research Centre, University of Copenhagen, Hvidovre Hospital, Hvidovre6 Department of Infectious Diseases, Odense University Hospital7 UCL Institute of Child Health8 Paediatric and International Nutrition, Department of Nutrition, Exercise and Sports, Faculty of Science, Københavns Universitet9 Paediatric Nutrition and International Nutrition, Department of Human Nutrition, Faculty of Life Sciences, Københavns Universitet10 Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, Københavns Universitet
Underweight is common among tuberculosis (TB) patients. However, there is little information on determinants of body composition at TB treatment initiation in high-TB-burdened countries. This study aimed to determine factors associated with body composition at commencement of TB treatment in Mwanza, Tanzania. A cross-sectional study was conducted from 2007 to 2008 among newly diagnosed TB patients. Fat and fat-free mass were determined using a deuterium dilution technique and fat and fat-free mass indices were computed. Correlates were assessed using multiple regression analysis. A total of 201 pulmonary TB patients were recruited; of these, 37.8% (76) were female, 51.7% (104) were HIV infected, 65.3% (126) had sputum-positive TB, and 24.4% (49) were current smokers. In multiple regressions analysis, males had a 2.2-kg/m(2) [(95% CI = 1.6, 2.9); P <0.0001] lower fat mass index but 1.5 kg/m(2) [(95% CI = 0.9, 2.0); P <0.0001] higher fat-free mass index compared with females. Sputum-positive TB was associated with a lower fat mass index among HIV-uninfected patients [-1.4 kg (95% CI = -2.5, -0.4); P = 0.006] but not among HIV-infected patients (P-interaction = 0.09). Current smokers had a 0.7-kg/m(2) [(95% CI = 0.02, 1.5); P= 0.045] lower fat mass index, but smoking did not affect fat-free mass. High socioeconomic status (SES) was associated with higher fat as well as fat-free mass. HIV infection, cluster of differentiation 4 count, and antiretroviral therapy were not correlates. Sex, smoking, and SES were associated with body composition of TB patients at treatment commencement. Prospective studies are needed to determine the role of these factors on weight gain, functional recovery, and survival during and after treatment. J. Nutr. 143: 735-741, 2013.
Journal of Nutrition, 2013, Vol 143, Issue 5, p. 735-741
AIDS-Related Opportunistic Infections; Adipose Tissue; Adolescent; Adult; Body Composition; Body Fluid Compartments; Cross-Sectional Studies; Deuterium; Female; HIV Infections; Humans; Indicator Dilution Techniques; Male; Middle Aged; Regression Analysis; Sex Factors; Smoking; Social Class; Sputum; Tanzania; Tuberculosis; Young Adult