title: Sex, smoking, and socioeconomic status are associated with body composition among tuberculosis patients in a deuterium dilution cross-sectional study in Mwanza, Tanzania.
abstract: Underweight is common among tuberculosis (TB) patients. However, there is little information on determinants of body composition at TB treatment initiation in high-TB-burdened countries. This study aimed to determine factors associated with body composition at commencement of TB treatment in Mwanza, Tanzania. A cross-sectional study was conducted from 2007 to 2008 among newly diagnosed TB patients. Fat and fat-free mass were determined using a deuterium dilution technique and fat and fat-free mass indices were computed. Correlates were assessed using multiple regression analysis. A total of 201 pulmonary TB patients were recruited; of these, 37.8% (76) were female, 51.7% (104) were HIV infected, 65.3% (126) had sputum-positive TB, and 24.4% (49) were current smokers. In multiple regressions analysis, males had a 2.2-kg/m(2) [(95% CI = 1.6, 2.9); P < 0.0001] lower fat mass index but 1.5 kg/m(2) [(95% CI = 0.9, 2.0); P < 0.0001] higher fat-free mass index compared with females. Sputum-positive TB was associated with a lower fat mass index among HIV-uninfected patients [-1.4 kg (95% CI = -2.5, -0.4); P = 0.006] but not among HIV-infected patients (P-interaction = 0.09). Current smokers had a 0.7-kg/m(2) [(95% CI = 0.02, 1.5); P = 0.045] lower fat mass index, but smoking did not affect fat-free mass. High socioeconomic status (SES) was associated with higher fat as well as fat-free mass. HIV infection, cluster of differentiation 4 count, and antiretroviral therapy were not correlates. Sex, smoking, and SES were associated with body composition of TB patients at treatment commencement. Prospective studies are needed to determine the role of these factors on weight gain, functional recovery, and survival during and after treatment.
authors.affiliation: National Institute for Medical Research, Mwanza Centre, Tanzania. gpraygod@yahoo.com
authors.forename: George
authors.initials: G
authors.lastname: PrayGod
authors.forename: Nyagosya
authors.initials: N
authors.lastname: Range
authors.forename: Daniel
authors.initials: D
authors.lastname: Faurholt-Jepsen
authors.forename: Kidola
authors.initials: K
authors.lastname: Jeremiah
authors.forename: Maria
authors.initials: M
authors.lastname: Faurholt-Jepsen
authors.forename: Martine G
authors.initials: MG
authors.lastname: Aabye
authors.forename: Pascal
authors.initials: P
authors.lastname: Magnussen
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.forename: Aase B
authors.initials: AB
authors.lastname: Andersen
authors.forename: Jonathan C K
authors.initials: JC
authors.lastname: Wells
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000273:Adipose Tissue; D000293:Adolescent; D000328:Adult; D001823:Body Composition; D001825:Body Fluid Compartments; D003430:Cross-Sectional Studies; D003903:Deuterium; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007201:Indicator Dilution Techniques; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D013183:Sputum; D013636:Tanzania / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications; D055815:Young Adult
chemical_list: D003903:Deuterium