Predictors of body composition changes during tuberculosis treatment in Mwanza, Tanzania

PrayGod, George; Range, Nyagosya; Faurholt‐Jepsen, Daniel; Jeremiah, Kidola; Faurholt‐Jepsen, Maria; Aabye, Martine G.; Magnussen, Pascal; Changalucha, John; Andersen, Aase Bengaard; Wells, Jonathan C. K.; Friis, Henrik

doi:10.1038/ejcn.2015.37

Cited by 8 publications

(7 citation statements)

References 41 publications

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“…In a prior study, sex did not affect mean weight gain during TB treatment, but male patients gained relatively more fat-free mass whereas female patients gained relatively more fat mass. 21 In this study, there was also a trend towards a negative association between MDR-TB and percentage weight gain. However, the low number of patients with MDR-TB likely led to the lack of significance of this association.…”

Section: Discussionsupporting

confidence: 55%

Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America

Phan

Guy

Nickson

et al. 2016

International Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 55%

Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America

Phan

Guy

Nickson

et al. 2016

International Journal of Infectious Diseases

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“…Men have a higher relative content of muscle, whereas women have a higher relative fat content (31). Additionally, there may be differences in the way men and women benefit from their body composition, when they are healthy or ill (32). These differences may be especially evident during the stress induced by infection.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory markers as correlates of body composition and grip strength among adults with and without HIV: A cross-sectional study in Ethiopia

et al. 2022

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Background: Changes in body composition and muscle strength are common among individuals with HIV. We investigated the associations of inflammation with body composition and grip strength in adults with and without HIV. Methods: Cross-sectional study among Ethiopian treatment-naïve individuals with and without HIV. Fat mass and fat-free mass adjusted for height (kg/m 2 ) were used as indicators of body composition. Results: 288/100 individuals with/without HIV were included between July 2010 and August 2012.Females with HIV had lower fat mass index (FMI) and fat-free mass index (FFMI) than females without HIV, whereas no difference was seen between males with and without HIV. Males and females with HIV had lower grip strength than their counterparts without HIV. Serum alpha-1-acid glycoprotein (s-AGP) was negatively correlated with FMI (-0.71 kg/m 2 , 95% CI: -1.2; -0.3) among individuals with HIV, and those with HIV and serum C-reactive protein (s-CRP) ≥10 mg/l had 0.78 kg/m 2 (95% CI -1.4; -0.2) lower FMI than those with s-CRP <10 mg/l. In contrast, s-AGP was positively correlated with FMI (2.09 kg/m 2 , 95% CI 0.6; 3.6) in individuals without HIV. S-CRP and AGP were negatively associated with grip strength in individuals with HIV, while no correlation was observed among those without HIV. Conclusion:Inflammation was positively associated with FMI in individuals without HIV while it was negatively associated with FMI in those with HIV, indicating that inflammation may be one of the drivers of depleting energy reserves among treatment-naïve individuals with HIV. Inflammation was associated with decreased muscle quantity and functional capacity among individuals with HIV, but not in those without HIV.

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“…In both Africans and Americans, HIV infection was associated with greater loss of fat-free mass in men than in women ( 34 ). Among Africans with tuberculosis-associated wasting, men gained more lean mass and women more fat mass during treatment ( 35 , 36 ). Furthermore, there may be a sex differential in survivor bias after severe malnutrition: men in the NUSTART study, one component of the CICADA cohort, were more likely to die soon after recruitment to NUSTART ( 28 ), and males were less likely to survive famine in China ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Prior undernutrition and insulin production several years later in Tanzanian adults

Filteau

PrayGod

Rehman

et al. 2021

The American Journal of Clinical Nutrition

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Background The prevalence, pathology, and existence of malnutrition-associated diabetes remain uncertain, especially with respect to adult-acquired undernutrition. Objective The aim was to investigate the association of prior undernutrition (low BMI, in kg/m2), acquired in adulthood and insulin during an oral glucose tolerance test (OGTT). Methods We followed up 630 adults recruited 7–14 y previously for other studies. Plasma insulin was measured fasting and at 30 and 120 min during an OGTT. The main exposure was BMI measured 7–14 y prior. The main outcome of interest was plasma insulin, controlling for time during the OGTT using generalized estimating equations, and exploratory outcomes were early insulin response (relative change in insulin and glucose from 0–30 min) and relative insulin and glucose AUCs from 0 to 120 min. Current confounding factors were age, sex, BMI, HIV, socioeconomic status, and physical activity. Results In unadjusted analyses, increasing severity of prior malnutrition was associated with lower insulin concentration. In multivariate adjusted analyses, only current BMI was a strong predictor of overall insulin concentration. Associations with prior BMI of insulin responses accounting for glucose were also seen in unadjusted but not adjusted analyses. For insulin concentration but not the outcomes accounting for glucose, there was a sex interaction with prior BMI such that only men had lower insulin if previously malnourished: insulin (pmol/L) at 120 min was 311 (95% CI: 272, 351) for prior BMI ≥18.5, 271 (95% CI: 221, 321) for prior BMI 17.0–18.5, and 237 (95% CI: 194, 297) for prior BMI <17.0; P = 0.03. HIV status showed limited and variable associations with insulin. Conclusions Insulin concentration, fasting and during an OGTT, was normalized in women more than in men several years after adult malnutrition. Chronic malnutrition, as indicated by low prior and current BMI, may contribute to diabetes through low insulin secretion.

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Predictors of body composition changes during tuberculosis treatment in Mwanza, Tanzania

Abstract: During intensive phase of TB treatment, sex, smoking and ART were predictors of body composition. Larger studies are needed to further understand predictors of body composition during recovery, to help design interventions to improve treatment outcomes.

Cited by 8 publications

References 41 publications

Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America

Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America

Inflammatory markers as correlates of body composition and grip strength among adults with and without HIV: A cross-sectional study in Ethiopia

Prior undernutrition and insulin production several years later in Tanzanian adults

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