Background: 

People with HIV (PWH) are at an increased risk for adiposity and sarcopenia, despite effective antiretroviral therapy. Our objective was to compare the effects of prescribed exercise on body composition in older PWH and uninfected controls.

Setting: 

Academic medical center.

Methods: 

Sedentary PWH (n = 27) and uninfected controls (n = 28) aged 50–75 years completed 24 weeks of cardiovascular and resistance exercise. Participants completed 12 weeks of moderate-intensity exercise and then were randomized to moderate- or high-intensity exercise for 12 additional weeks. Total lean (LEAN) and fat mass (FAT), and visceral adipose tissue area (VAT) were measured using dual-energy x-ray absorptiometry at baseline and 24 weeks; baseline and intervention differences were compared by HIV serostatus using multivariable regression analyses adjusted for baseline values, age, and exercise adherence.

Results: 

At baseline, PWH had significantly lower FAT (P = 0.003), but no significant differences in LEAN or VAT compared with controls (P > 0.20). Changes over 24 weeks were not significantly different by HIV serostatus, although controls tended to gain more LEAN (0.8 kg; range, 0–1.6 kg; P = 0.04] than PWH (0.6 kg; range, −0.2 to 1.4 kg; P = 0.12) and lose less FAT and VAT (controls: (−0.9 kg; range, −1.8 to 0.0 kg and −10.3 cm²; range, −19.6, 1.0) cm²; both P = 0.03 vs PWH: −2.0 kg; range, −2.9 to −1.1 kg and −17.7 cm²; range, −27.1 to −8.2 cm²; both P < 0.001). Exercise intensity differences were not apparent for LEAN, FAT, or VAT.

Conclusions: 

Exercise reduced total and visceral fat in older PWH and controls. Minimal gains in lean mass suggest that greater emphasis on resistance exercise may be needed to more effectively increase muscle in PWH.

中文翻译：

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患有或未感染HIV的老年人对中度或高强度运动的反应所引起的身体成分变化

背景： 

与人HIV（威尔斯亲王医院）是在对风险增加肥胖和肌肉减少，尽管有效的抗逆转录病毒疗法。我们的目的是比较处方运动对老年PWH和未感染对照者身体成分的影响。

设置： 

学术医学中心。

方法： 

年龄在50-75岁之间的久坐PWH（n = 27）和未感染对照（n = 28）完成了24周的心血管和抵抗运动。参与者完成了12周的中等强度运动，然后再随机分组进行中等强度或高强度运动12周。在基线和24周时使用双能X线吸收法测量总瘦肉（LEAN）和脂肪量（FAT）以及内脏脂肪组织面积（VAT）；使用多变量回归分析，通过HIV血清状况比较基线和干预差异，并针对基线值，年龄和运动依从性进行调整。

结果： 

在基线时，PWH的FAT显着降低（P = 0.003），但与对照组相比，LEAN或VAT没有显着差异（P > 0.20）。HIV血清状况在24周内的变化无显着差异，尽管对照人群的LEAN（0.8 kg；范围0–1.6 kg； P = 0.04）往往比PWH（0.6 kg；范围-0.2至1.4 kg；P = 0.12）并减少FAT和VAT（对照：（-0.9 kg;范围-1.8至0.0 kg和-10.3 cm ² ;范围-19.6，1.0）cm ² ; P = 0.03 vs PWH：-2.0 kg;范围-2.9至-1.1 kg和-17.7 cm ²；范围-27.1至-8.2 cm ²；均P<0.001）。对于LEAN，FAT或VAT，运动强度差异不明显。

结论： 

锻炼可以减少老年PWH和对照组的总脂肪和内脏脂肪。瘦体重的最小增加表明，可能需要更加重视抵抗运动，才能更有效地增加PWH的肌肉。