       Document 0460
 DOCN  M9590460
 TI    Energy expenditure and wasting in human immunodeficiency virus infection
       [see comments]
 DT    9509
 AU    Macallan DC; Noble C; Baldwin C; Jebb SA; Prentice AM; Coward WA; Sawyer
       MB; McManus TJ; Griffin GE; Division of Infectious Diseases, St.
       George's Hospital Medical; School, London, United Kingdom.
 SO    N Engl J Med. 1995 Jul 13;333(2):83-8. Unique Identifier : AIDSLINE
       MED/95295805
 CM    Comment in: N Engl J Med 1995 Jul 13;333(2):123-4
 AB    BACKGROUND. Increased expenditure of energy at rest has been considered
       a contributing factor to the negative energy balance and weight loss
       that occur in patients with human immunodeficiency virus (HIV)
       infection. However, the true determinant of energy balance is not
       resting but total energy expenditure. We sought to determine the
       contribution of total energy expenditure to weight changes in patients
       with HIV-associated wasting. METHODS. We performed 51 assessments of
       energy metabolism in 27 men with HIV infection at different stages of
       disease, including periods of both rapid and slow weight loss. Resting
       energy expenditure was measured by indirect calorimetry, total energy
       expenditure by the doubly-labeled-water technique, and energy intake by
       recording the weight of food consumed. The results were compared with
       the rate of weight loss or gain. RESULTS. The mean (+/- SD) total energy
       expended by the HIV-infected men was 2750 +/- 670 kcal per day, no more
       than that expended by normal men. There was a significant positive
       relation between total energy expenditure and the rate of weight change
       (r = 0.61, P < 0.001); thus, during rapid weight loss, total energy
       expenditure was reduced to 2180 +/- 580 kcal per day (P = 0.009),
       primarily because of reduced physical activity. During rapid weight
       loss, the negative energy balance (-850 +/- 580 kcal per day) was
       primarily the result of the reduction in energy intake, to 1330 +/- 610
       kcal per day; intake correlated strongly with the rate of weight change
       (r = 0.84, P < 0.001). CONCLUSIONS. In patients with HIV infection,
       total energy expenditure is reduced during episodes of weight loss.
       Reduced energy intake, not elevated energy expenditure, is the prime
       determinant of weight loss in HIV-associated wasting.
 DE    Adult  Cachexia/ETIOLOGY  *Caloric Intake  Case-Control Studies  *Energy
       Metabolism  Human  HIV Infections/COMPLICATIONS/*METABOLISM  Male
       Middle Age  Support, Non-U.S. Gov't  Weight Loss/*PHYSIOLOGY  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

