title: Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda.
abstract: OBJECTIVE
  We assessed the impact of wasting on survival in patients with tuberculosis by using a precise height-normalized lean tissue mass index (LMI) estimated by bioelectrical impedance analysis and body mass index (BMI).
  
  
  METHODS
  In a retrospective cohort study, 747 adult pulmonary patients with tuberculosis who were screened for HIV and nutritional status were followed for survival.
  
  
  RESULTS
  Of 747 patients, 310 had baseline wasting by BMI (kg/m(2)) and 103 by LMI (kg/m(2)). Total deaths were 105. Among men with reduced BMI, risk of death was 70% greater (hazard ratio [HR] 1.7, 95% confidence interval [95% CI] 1.03-2.81) than in men with normal BMI. Survival did not differ by LMI among men (HR 1.1; 95% CI 0.5-2.9). In women, both the BMI and LMI were associated with survival. Among women with reduced BMI, risk of death was 80% greater (HR 1.8; 95% CI 0.9-3.5) than in women with normal BMI; risk of death was 5-fold greater (HR 5.0; 95% CI 1.6-15.9) for women with low LMI compared with women with normal LMI.
  
  
  CONCLUSIONS
  Wasting assessed by reduced BMI is associated with an increased risk for death among both men and women whereas reduced LMI is among women with tuberculosis.
authors.affiliation: Department of Paediatrics & Child Health, College of Health Sciences, Makerere University Kampala, Uganda. mupez@yahoo.com
authors.forename: Ezekiel
authors.initials: E
authors.lastname: Mupere
authors.forename: Lashaunda
authors.initials: L
authors.lastname: Malone
authors.forename: Sarah
authors.initials: S
authors.lastname: Zalwango
authors.forename: Allan
authors.initials: A
authors.lastname: Chiunda
authors.forename: Alphonse
authors.initials: A
authors.lastname: Okwera
authors.forename: Isabel
authors.initials: I
authors.lastname: Parraga
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Stein
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Tisch
authors.forename: Roy
authors.initials: R
authors.lastname: Mugerwa
authors.forename: W Henry
authors.initials: WH
authors.lastname: Boom
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Whalen
mesh_terms: D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D002100:Cachexia / Q000401:mortality*; D015331:Cohort Studies; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000150:complications; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000401:mortality*; D014454:Uganda / Q000453:epidemiology; D014505:Urban Population; D019282:Wasting Syndrome / Q000209:etiology / Q000401:mortality*