Journal
ANNALS OF EPIDEMIOLOGY
Volume 22, Issue 7, Pages 466-473Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.annepidem.2012.04.007
Keywords
Tuberculosis; Survival; Wasting; Lean Tissue Mass Index; Body Mass Index; Bioelectrical Impedance Analysis
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Funding
- Fogarty International Center [TW00011]
- Tuberculosis Research Unit from National Institute of Allergy and Infectious Diseases [NOI-A195383, HHSN266200700022C/N01-AI70022,, A132414]
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OBJECTIVES: 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. Ann Epidemiol 2012;22:466-473. (C) 2012 Elsevier Inc. All rights reserved.
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