Document Detail

Determinants of increased energy expenditure in HIV-infected women.
MedLine Citation:
PMID:  9734753     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known about sex-specific effects of HIV infection on energy expenditure. OBJECTIVE: We investigated the determinants of energy expenditure in HIV-infected women. DESIGN: Resting energy expenditure (REE), body composition, and hormonal and nutritional indexes were compared in 33 ambulatory, premenopausal HIV-infected women and 26 weight-matched, healthy premenopausal control subjects. REE was determined by indirect calorimetry and body composition by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis, and skinfold-thickness analysis. Hormonal indexes included leptin, testosterone, estradiol, and insulin-like growth factor I. RESULTS: HIV-infected subjects had a higher REE than control subjects [6794 +/- 1374 compared with 6011 +/- 607 kJ/d (1624 +/- 329 compared with 1437 +/- 145 kcal/d), P = 0.0096]. On average, REE was 119 +/- 23% of Harris-Benedict predictions in HIV-infected subjects compared with 102 +/- 9% for control subjects (P = 0.0007). In HIV-infected subjects, REE was highly correlated with fat-free mass (FFM) by DXA (R = 0.641, P < 0.001), but not with weight or disease status. The slope of the regression equation for REE and FFM was significantly greater (P = 0.027, analysis of covariance) for HIV-infected subjects [REE (kJ/d) = 203.5 (kg FFM) - 1237] than for control subjects [REE (kJ/d) = 77.4 (kg FFM) + 2923]. In a stepwise regression analysis, FFM was the most significant variable (P = 0.005), followed by free testosterone (P = 0.029), which together explained 49% of the variation in REE. The final equation was REE (kJ/d) = 230.8 (kg FFM) + 395.9 (free testosterone, pmol/L) - 3304. CONCLUSIONS: Energy expenditure was higher in HIV-infected women than in control women. FFM is the primary determinant of REE in HIV-infected women, but energy expenditure is greater per kg FFM in HIV-infected subjects than in control subjects, which may contribute to the wasting syndrome.
S Grinspoon; C Corcoran; K Miller; E Wang; J Hubbard; D Schoenfeld; E Anderson; N Basgoz; A Klibanski
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  68     ISSN:  0002-9165     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-29     Completed Date:  1998-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  720-5     Citation Subset:  AIM; IM; X    
Neuroendocrine Unit, General Clinical Research Center, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
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MeSH Terms
Absorptiometry, Photon
Basal Metabolism*
Body Composition
Body Mass Index
Calorimetry, Indirect
Case-Control Studies
Electric Impedance
Energy Intake
Gonadal Steroid Hormones / blood
HIV Infections / metabolism*
Premenopause / metabolism
Proteins / metabolism
Regression Analysis
Grant Support
Reg. No./Substance:
0/Gonadal Steroid Hormones; 0/Leptin; 0/Proteins
Comment In:
Am J Clin Nutr. 1999 Aug;70(2):299-300; author reply 301   [PMID:  10426709 ]
Am J Clin Nutr. 1998 Sep;68(3):519-20   [PMID:  9734723 ]

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