Presentation Abstract

Simple Nutrition Evaluation Measures Provide Clues For Early Intervention in Weight Loss. TA Larson, BJ Scott, RL Brunner, S Navarro. University of Nevada, School of Medicine, Reno.

Objective: To identify markers of wasting early in HIV disease through intensive nutritional evaluation of patients in an ambulatory community based HIV care clinic in a prospective and longitudinal study. Methods: Subjects included 35 (29 male [83%]; 6 female [17%]) relatively healthy HIV-infected adults (mean age=39.4±10.3 years.). Objective measurements of weight, height, grip strength, skinfolds, arm circumference, dietary intake (from 7 day food record) and resting energy expenditure (measured by portable indirect calorimetry) were obtained. Triceps skinfold, arm circumference, and arm muscle area were expressed in percentiles by gender and age. Body mass index was calculated using wt (kg)/ht2 (m), and percent ideal body weight was determined by actual weight/ideal weight for gender and height. Subjects were stratified by CD4 cell count into 3 groups: A >300; B 101-300; and C ² 100. Data were analyzed using ANOVAs (SPSS for Windows) to detect differences in these nutritional measurements between the CD4 groups.

Results: Comparison of nutritional measurements by group revealed significantly decreasing hand grip between Group A and Groups B and C (p² 0.04). Trends were apparent in declining triceps skinfold percentiles, arm circumference percentiles, percent ideal weight, body mass index, and mean weight from Group A to Group C. There were no differences in calories consumed per kilogram body weight or in oxygen consumption per kilogram body weight.

Conclusion: In this group at baseline, the relatively simple measurements of muscle strength (hand grip) and muscle mass (triceps skinfolds and arm circumference) correlate with CD4 count and weight. These candidate markers will undergo longitudinal evaluation, monitoring changes in each patient over time, to further define their utility.

Contact: Trudy A. Larson, Department of Pediatrics, 411 W. 2nd St., Reno, NV 89503, USA. Telephone: 775.784.6170, Fax: 775.784.4828 email: tal@unr.med.edu.

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