Energy Expenditure, Activity, and Aging With HIV:Effects on Functional Longevity

HIV 感染者的能量消耗、活动和衰老：对功能寿命的影响

• 批准号: 9104073
• 负责人: JENNIFER ANN SCHRACK
• 金额: $ 12.93万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9104073
• 关键词: Accelerometer; Acquired Immunodeficiency Syndrome; Activities of Daily Living; Address; Age; Aging; Anti-Retroviral Agents; Arthritis; Baltimore; Basal metabolic rate; Biological Markers; Body Composition; CD4 Lymphocyte Count; Carbon Dioxide; Cessation of life; Chronic lung disease; Circadian Rhythms; Clinical; Cohort Studies; Comorbidity; Consumption; Data; Diabetes Mellitus; Education; Employment; Energy Metabolism; Exhibits; Fatigue; Fatty acid glycerol esters; Future; Gait speed; Goals; HIV; HIV Infections; Health; Health Status; Hepatitis B; Hepatitis C; Hyperlipidemia; Hypertension; Independent Living; Individual; Infection; Inflammation; Interleukin-6; Intervention; Kidney Diseases; Knowledge; Lead; Life; Life Expectancy; Liver diseases; Longevity; Measures; Mediating; Methods; Modeling; Movement; NIH Office of AIDS Research; Output; Participant; Pattern; Persons; Pharmaceutical Preparations; Physical Function; Physical activity; Physiological; Physiology; Population; Production; Public Health; Quality of life; Race; Regimen; Rehabilitation therapy; Reporting; Research; Rest; Risk; Role; Serum; Site; Smoking; Time; United States; Viral Load result; Walking; Work; age related; aged; antiretroviral therapy; base; co-infection; combat; cost; design; disability; frailty; functional decline; high risk; improved; improved functioning; inflammatory marker; insight; lean body mass; men; metabolic rate; repaired; social; working group

DESCRIPTION (provided by applicant): Background: An estimated 31% of HIV-infected (HIV+) individuals in the United States are aged 50 or older. These individuals are at heightened risk of functional decline due to physiological mechanisms that contribute to increased inflammation and alterations in body composition even after effective antiretroviral treatment. Over time, this may contribute to persistently elevated metabolic rate and decreased availability of energy for daily physical activities, as a greater proportion of energy is needed to combat comorbid conditions and repair cellular damage. Recent evidence indicates that in the older, less resilient population, this may accelerate the onset of frailty, disability, and death. Methods To assess and quantify the accelerated onset and temporal dynamics of functional decline in the aging HIV-infected population, we propose to assess gait speed, resting metabolic rate, walking energy expenditure, and objectively measured physical activity in virologically suppressed HIV+ and HIV- men in the Baltimore Multicenter AIDS Cohort Study (MACS). We hypothesize that: (i) gait speed will be slower in HIV+ men and will decrease faster with age relative to HIV- men, (ii) energy expenditure at rest and during standard walking (O2 consumption and CO2 production) will both be elevated in HIV+ men relative to HIV- men, (iii) the association between higher energy expenditure and slower gait speed will be mediated by higher levels of inflammatory markers (e.g., IL-6) and lower lean mass, (iv) HIV+ men will exhibit lower cumulative daily physical activity with more pronounced evidence of fatigue-driven activity patterns than HIV- men, and (v) HIV+ men will have lower day-to-day variability and complexity of circadian rhythms of activity relative to HIV- men. Output: The data obtained from this research will provide critical insight into (i) the amount of excess energy needed for independent living in those with treated HIV infection, and (ii) the associated threats to physical activity an functional mobility. We will use these data as the basis for a future R01 submission designed to: (i) longitudinally evaluate energy expenditure at rest and during walking as causal biomarkers of functional health status and (ii) provide evidence for interventions aimed at: (a) increasing walking efficiency by lowering energy costs through rehabilitative therapy to improve body composition and/or altered drug regimens to lower inflammation, and (b) increasing physical activity and reducing fatigue by targeting low-points of daily activity through analysis of circadin activity patterns. This will contribute to improved function and reduced risk of frailty, disabilit, and death in aging HIV populations.

描述（由申请人提供）：背景：美国估计31％的HIV感染（HIV+）个体年龄在50岁以上。由于生理机制，即使在有效的抗逆转录病毒治疗后，这些人的功能下降风险越高，这些机制有助于增加身体组成。随着时间的流逝，这可能有助于持续升高的代谢率和日常体育活动的能源可用性降低，因为需要更大比例的能量来打击合并症和修复细胞损伤。最近的证据表明，在较老的，弹性较低的人群中，这可能会加速脆弱，残疾和死亡的发作。评估和量化衰老HIV感染人群功能下降的加速发作和时间动态的方法，我们建议评估步态速度，静息代谢率，步行能量消耗以及客观地测量在病毒学抑制的HIV+ HIV+和HIV的人的身体活动中，巴尔蒂莫尔多中心辅助研究（MACS Macs）。 We hypothesize that: (i) gait speed will be slower in HIV+ men and will decrease faster with age relative to HIV- men, (ii) energy expenditure at rest and during standard walking (O2 consumption and CO2 production) will both be elevated in HIV+ men relative to HIV- men, (iii) the association between higher energy expenditure and slower gait speed will be mediated by higher levels of inflammatory markers (e.g., IL-6)和较低的瘦肉肿块，（IV）HIV+男性将表现出比HIV-MEN的累积累积每日体育活动，并且比HIV-MEN更明显，并且（v）HIV+男性将具有较低的日常变异性和相对于HIV患者的昼夜节律节奏的差异。输出：从这项研究中获得的数据将为（i）独立生活所需的多余能量量提供关键的见解，以及（ii）对体育活动的相关威胁是功能性流动性。我们将使用这些数据作为未来R01提交的基础：（i）作为功能健康状况的因果生物标志物，纵向评估静止和步行过程中的能量支出，并且（ii）提供了针对干预措施的证据：（a）通过降低体内和改善体内的药物来降低体能（降低体力降低体力）的步行效率（a），以提高体力和改善药物（改善药物的体重）（降低体力较低的药物（降低体力））通过分析Circadin活性模式来靶向低点日常活动的疲劳。这将有助于改善功能，并降低艾滋病毒衰老人群的脆弱，不稳定和死亡的风险。