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. 2012 Jul;22(7):466-73.
doi: 10.1016/j.annepidem.2012.04.007. Epub 2012 May 9.

Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda

Ezekiel Mupere  1 , Lashaunda Malone, Sarah Zalwango, Allan Chiunda, Alphonse Okwera, Isabel Parraga, Catherine M Stein, Daniel J Tisch, Roy Mugerwa, W Henry Boom, Harriet Mayanja, Christopher C Whalen
Affiliations

Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda

Ezekiel Mupere et al. Ann Epidemiol. 2012 Jul.

Abstract

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.

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Conflict of interest statement

Conflict of Interest and Sources of Funding

Author disclosures: Mupere E, Malone L, Zalwango S, Chiunda A, Okwera A, Parraga MI, Stein CM, Tisch JD, Mugerwa R, Boom WH, Mayanja KH, and Whalen CC reported no conflict of interest.

Figures

Figure 1
Figure 1
A. Survival distribution among adult tuberculosis patients presenting with wasting (BMI <18.5 kg/m2) compared to patients without wasting. B. Survival distribution among adult male tuberculosis patients presenting with wasting (BMI <18.5 kg/m2) compared to men without wasting in urban Uganda.
Figure 2
Figure 2
A. Survival distribution among adult tuberculosis patients presenting with baseline lean tissue mass wasting (LMI <14.6 kg/m2) compared to patients without wasting. B. Survival distribution among adult female tuberculosis patients presenting with lean tissue wasting (LMI <14.6 kg/m2) compared to female patients without wasting.
See this image and copyright information in PMC

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