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American Journal of Clinical Nutrition, Vol 57, 15-19, Copyright © 1993 by The American Society for Clinical Nutrition, Inc


ORIGINAL RESEARCH COMMUNICATIONS

Early changes of body composition in human immunodeficiency virus- infected patients: tetrapolar body impedance analysis indicates significant malnutrition

M Ott, B Lembcke, H Fischer, R Jager, H Polat, H Geier, M Rech, S Staszeswki, EB Helm and WF Caspary
Department of Medicine, University Hospital, Johann Wolfgang Goethe- University, Frankfurt, Germany.

Total body water, body fat, body cell mass (BCM), extracellular mass (ECM), and the ECM-BCM ratio by impedance analysis were determined in 193 human immunodeficiency virus (HIV)-infected patients and 340 control subjects. Walter Reed (WR) classification was WR 2 in 26, WR 3- 5 in 85, and WR 6 in 82 patients. Whereas resistance was increased, reactance and the phase angle were significantly reduced in all patient groups. Neither body weight nor body mass index (BMI) was affected in WR 2 patients, but BCM was reduced (31.9 +/- 4.3 vs 35.8 +/- 7.3 kg, P < 0.007) and ECM (31.2 +/- 4.4 vs 28.8 +/- 3.8 kg) as well as ECM-BCM ratio increased (0.99 +/- 0.14 vs 0.83 +/- 0.16, P < 0.001). In contrast to WR classification, diarrhea did not correspond with malnutrition. A loss of BCM (malnutrition) occurred already in otherwise symptomless HIV-infected patients (WR 2). This effect can be measured by tetrapolar impedence analysis but not by body weight or BMI.


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