학술논문

HIV infection and increased food insecurity are associated with adverse body composition changes among pregnant and lactating Kenyan women
Document Type
article
Source
European Journal of Clinical Nutrition. 73(3)
Subject
Reproductive Medicine
Biomedical and Clinical Sciences
Nutrition and Dietetics
HIV/AIDS
Infectious Diseases
Clinical Research
Nutrition
Reproductive health and childbirth
Infection
Zero Hunger
Adult
Anthropometry
Anti-Retroviral Agents
Body Composition
Breast Feeding
Cohort Studies
Comorbidity
Female
Food Supply
HIV Infections
Humans
Kenya
Lactation
Longitudinal Studies
Postpartum Period
Pregnancy
Pregnancy Complications
Infectious
Puerperal Disorders
Young Adult
Food Sciences
Human Movement and Sports Sciences
Nutrition & Dietetics
Clinical sciences
Nutrition and dietetics
Language
Abstract
Background/objectivesBody composition changes markedly during reproduction. In sub-Saharan Africa, impacts of HIV infection on body composition across pregnancy and lactation in the context of Option B+ antiretroviral therapy are unknown. Therefore, we sought to evaluate the role of HIV infection on body composition during pregnancy and lactation among Kenyan women.Subjects/methodsA cohort of pregnant women (n = 333; 50.5% HIV+, receiving ART) were enrolled at seven clinics in western Kenya. Two prenatal (mean ± SD: 23.6 ± 4.4 and 33.4 ± 2.0 weeks gestation) and three postpartum (6, 14, and 36 weeks) measurements included: individual-level food insecurity, height, weight, fat mass (FM), and fat-free mass (FFM) by bioimpedance analysis (BIA), mid-upper arm circumference (MUAC), and triceps skinfold (TSF), allowing for AMA (arm muscle area) and AFA (arm fat area) derivation. Multivariable longitudinal regression models were used to relate HIV to body composition changes.ResultsIn longitudinal models, HIV-infected women had lower weight (ß = -3.0 kg, p = 0.003), fat mass (ß = -1.5 kg, p = 0.02), fat-free mass (ß = -1.5 kg, p = 0.01), TSF (ß = -2.6 mm, p