Factors associated with skeletal muscle mass in middle-aged men living with HIV

IF 9.4 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2024-07-17 DOI:10.1002/jcsm.13545

Yide Xu, Dongdong Wang, Pei Chen, Bufeng Qi, Xiaoting Li, Chunfeng Xie, Jieshu Wu, Lin Li, Gu Gao, Shanshan Geng, Dandan Yang

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Abstract

Background

Despite extensive research on muscle loss in people living with HIV (PLWH), the prevalence and contributing factors specifically among middle-aged men remain unclear. This study aimed to determine the prevalence of low muscle mass within this demographic and to identify associated factors.

Methods

A total of 378 men living with HIV were enrolled in the study. They were classified into low muscle mass group if they displayed a skeletal muscle index (SMI) <7.00 kg/m² or fell within the lowest quintile of SMI based on the criteria established by the Asian Working Group for Sarcopenia 2019.

Results

Out of the 378 men living with HIV enrolled, 351 had normal muscle mass, while 27 (7.1%) had low muscle mass. Antiretroviral drugs Zidovudine (AZT) (OR = 0.246, P = 0.022) and higher serum albumin levels (OR = 0.899, P = 0.026) were found to be protective factors against low muscle mass according to quintile grouping. Strong positive associations between SMI and body mass index (BMI), nutritional risk index (NRI), oedema index and fat-free mass index (FFMI) (R > 0.5, P < 0.001) were observed. In addition, both BMI (sensitivity = 0.741, specificity = 0.906) and NRI (sensitivity = 0.963, specificity = 0.601) had high sensitivity and specificity in diagnosing low muscle mass, with critical values of 19.85 and 114.177 for BMI and NRI, respectively. The oedema index was the most effective measure of body composition in detecting abnormal fluid retention with high sensitivity (92.6%) and moderate specificity (71.8%) in identifying individuals with low muscle mass. Notably, PLWH with low muscle mass participants had a significantly higher prevalence (92.6%) of a high oedema index compared with those with normal muscle mass (28.2%). This observation indicates that individuals with HIV who experience reduced muscle mass is commonly accompanied with abnormal fluid retention within the body.

Conclusions

Antiretroviral medication types, specifically Zidovudine, BMI and NRI can be independent risk factors for low muscle mass in men with HIV. These factors, along with BMI, could be used conveniently to predict low muscle mass. Furthermore, the association between the oedema index and muscle mass suggests that observing signs of oedema may indicate a risk of low muscle mass in PLWH.

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感染艾滋病毒的中年男性骨骼肌质量的相关因素。

背景：尽管对艾滋病病毒感染者（PLWH）的肌肉流失进行了广泛的研究，但中年男性的发病率和诱发因素仍不清楚。本研究旨在确定低肌肉质量在这一人群中的流行率，并找出相关因素：方法：共有 378 名男性艾滋病病毒感染者参加了研究。根据亚洲肥胖症工作组 2019 年制定的标准，如果他们的骨骼肌指数（SMI）为 2 或属于 SMI 的最低五分位数，则被归入低肌肉质量组：在 378 名男性艾滋病感染者中，351 人的肌肉质量正常，27 人（7.1%）的肌肉质量较低。根据五分法分组发现，抗逆转录病毒药物齐多夫定（AZT）（OR = 0.246，P = 0.022）和较高的血清白蛋白水平（OR = 0.899，P = 0.026）是低肌肉质量的保护因素。SMI 与体重指数 (BMI)、营养风险指数 (NRI)、水肿指数和去脂体重指数 (FFMI) 之间存在很强的正相关性（R > 0.5，P 结论）：抗逆转录病毒药物类型（尤其是齐多夫定）、体重指数和营养风险指数可能是导致男性艾滋病患者肌肉质量低的独立风险因素。这些因素以及体重指数可用于预测低肌肉质量。此外，水肿指数与肌肉质量之间的关联表明，观察到水肿迹象可能预示着艾滋病毒感染者存在肌肉质量低的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.