The Influence of Habitual Physical Activity and Diet in the Development of Sarcopenia Among Older Adults With HIV

习惯性体力活动和饮食对老年艾滋病毒感染者肌肉减少症发展的影响

• 批准号: 10699259
• 负责人: Vitor Oliveira
• 金额: $ 26.03万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10699259
• 关键词: Acceleration; Address; Age; Age Years; Aging; Alcohol consumption; Anxiety; Behavior; Biological; Characteristics; Clinic; Clinical; Country; Data; Development; Diet; Dietary Intervention; Dietary intake; Disease; Drug usage; Dual-Energy X-Ray Absorptiometry; Economic Burden; Elderly; Future; General Population; Goals; HIV; HIV Infections; Health Care Costs; Health Promotion; Intervention; Intervention Studies; Knowledge; Length; Length of Stay; Life Expectancy; Life Style; Literature; Maintenance; Malnutrition; Mental Depression; Modeling; Morbidity - disease rate; Muscle function; Muscular Atrophy; Musculoskeletal Diseases; Observational Study; Older Population; Persons; Pharmacological Treatment; Physical Function; Physical activity; Physiological; Play; Population; Positioning Attribute; Prevalence; Process; Research Priority; Risk Factors; Role; Sampling; Scanning; Science; Site; Smoking; Stimulus; Symptoms; System; Time; Viral; Woman; age related; aged; antiretroviral therapy; biobehavior; clinically relevant; cohort; comorbidity; disability; exercise intervention; experience; falls; frailty; healthspan; high risk; human old age (65+); immunosenescence; lean body mass; lifestyle factors; medication compliance; modifiable lifestyle factors; mortality; muscle form; normal aging; novel; patient oriented; physical inactivity; prevent; primary outcome; reduced muscle mass; reduced muscle strength; response; sarcopenia; sedentary lifestyle; social factors; therapy adverse effect

ABSTRACT The life expectancy of people with HIV (PWH) in the U.S is increasing. HIV, together with normal aging, imposes additional challenges to an extended healthspan (i.e., the length of time that the person is healthy and not just alive) in this population. This includes an earlier occurrence of geriatric conditions such as sarcopenia, a musculoskeletal disease that can lead to falls, morbidity, loss of independence, disability, and mortality. Sarcopenia poses a significant economic burden, generating higher healthcare costs and more extended hospital stays for the sarcopenic population. Sarcopenia is highly prevalent (24%) among PWH, and we recently demonstrated that PWH are six times more likely to develop sarcopenia than people without HIV. Despite being prevalent among this population, few observational studies in PWH have included sarcopenia as a primary outcome, and we lack interventional studies targeting sarcopenia among PWH. The causes of sarcopenia are multifactorial, and despite being recognized as a debilitating disease, it has no effective pharmacological treatment. In the general population, physical inactivity and malnutrition are recognized contributors to sarcopenia, and exercise and diet interventions are the best ways to prevent and treat it. Among PWH, the causes of sarcopenia can include different HIV-associated factors. Lifestyle factors such as physical inactivity, sedentary behavior, and malnutrition are prevalent among PWH and can potentially contribute to sarcopenia in this population. However, these associations in HIV remain poorly explored, and whether these are the primary contributors to sarcopenia among PWH is unknown. This proposed study is uniquely positioned to address such gaps in the science by leveraging the ongoing multi-site PROSPER-HIV study (R01-NR-018391) focused on the association between physical activity, diet, and HIV symptoms in PWH by adding a whole-body dual-energy X‐ray absorptiometry scan. This will provide data on the amount of lean body mass and allow us to rigorously determine the presence of sarcopenia among PWH. The PROSPER-HIV study provides an ideal opportunity to explore the importance of these modifiable lifestyle behaviors on the healthspan of PWH and to answer how physical activity and diet can help in the multifactorial development and management of sarcopenia. Specifically, in 130 PWH ≥50 years of age, we will: 1) Examine the cross-sectional relationship between modifiable lifestyle factors (i.e., habitual physical activity levels and diet quality) and the presence of sarcopenia; and 2) Investigate to what extent current or prior exposures (i.e., symptom burden; medication adherence; smoking, alcohol, and drug use; the presence of depression and anxiety; clinical and demographic characteristics) predicts sarcopenia. Our scientific premise is that, on top of other factors leading to HIV-associated sarcopenia, lifestyle factors play an essential role and can be harnesseed as a non-pharmacologic strategy to reduce the prevalence of this debilitating comorbidity among PWH.

抽象的 在美国，艾滋病毒（PWH）患者的预期寿命正在增加。艾滋病毒，加上正常衰老， 不可能对扩展健康范围的挑战（即，该人的时间长度 健康，而不仅仅是活着）。这包括早期出现的老年疾病 例如肌肉减少症，一种可能导致下降，发病率，独立性丧失的肌肉骨骼疾病 残疾和死亡率。肌肉减少症具有巨大的经济燃烧，产生了更高的医疗费用 肌肉减少症人口的更多延长医院住院。肌肉减少症高度普遍（24％） PWH，我们最近证明，PWH发展肌肉减少症的可能性是人们的六倍 没有艾滋病毒。尽管在这个人群中流行，但PWH中很少有观察性研究 包括肌肉减少症是主要结果，我们缺乏针对肌肉减少症的介入研究 在PWH中。肌肉减少症的原因是多因素，目的地被认为是令人衰弱的 疾病，它没有有效的药物治疗。在一般人群中，身体不活动和 营养不良是肉骨减少症的贡献者，运动和饮食干预是最好的方法 预防和治疗它。在PWH中，肌肉减少症的原因可能包括不同的HIV相关因素。 诸如身体不活动，久坐行为和营养不良之类的生活方式因素很普遍 在PWH中，在该人群中可能有助于肌肉减少症。但是，这些 艾滋病毒中的关联仍然受到探索不佳，这些是否是肌肉减少症的主要因素 在PWH中是未知的。这项拟议的研究是独特的，可以解决科学中的此类差距 利用正在进行的多站点繁荣-HIV研究（R01-NR-018391）的重点 通过添加全身双能X射线，PWH的体育锻炼，饮食和HIV症状之间 绝对肽扫描。这将提供有关瘦体重的数据，并使我们严格 确定PWH中肌肉减少症的存在。 Prosper-HIV研究提供了理想的机会 探讨这些可修改的生活方式行为对PWH的健康状况的重要性，并回答 体育锻炼和饮食如何帮助肌肉减少症的多因素发展和管理。 具体而言，在130pwh≥50岁的年龄中，我们将：1）检查 可修改的生活方式因素（即习惯性体育锻炼水平和饮食质量）以及存在 肌肉减少症； 2）调查当前或先前的暴露程度（即症状伯恩；药物 依从性；吸烟，酒精和吸毒；抑郁和焦虑的存在；临床和 人口特征）预测肌肉减少症。我们的科学前提是，除了其他因素之外 导致与艾滋病毒相关的肌肉减少症，生活方式因素起着至关重要的作用，可以作为一种 降低PWH中这种令人衰弱的合并症患病率的非药物策略。