Effect of anti-tuberculosis treatment on body composition during the intensive phase

Abstract

Background: Nutritional changes during and after tuberculosis (TB) treatment have not been well described. Aim: Determine the mean change in body mass index (BMI), fat mass (FM) and fat free mass (FFM) as measured by bioelectrical impedance analysis (BIA) at baseline and after 2months of TB treatment. Methods: A prospective study was performed in a teaching hospital of Tunis. Patients followed up for pulmonary TB were included. At radiographs, lung disease extent was graded according to an international classification of TB. BMI and height-normalized indices of FFM and FM as measured by BIA (SC-240MA classIII, Tanita coporation, Tokyo, Japan) were assessed at baseline and after 2 months of standard TB treatment. Patients were studied in the morning after an overnight fast. Patients lost to follow up were excluded. Results: Of the 58 participants who were available, 9 were excluded due to lack of anthropometric follow-up data. Data about 49 participants were analyzed (16women and 33men). The mean age was 41.9±14.5years. At baseline, 15patients had an advanced lung disease. The mean BMI was 19.5±9.1 Kg/m2. Initial values of FFM and FM were respectively 47.4±9.2Kg and 9.9±8.5Kg. At 2 months of TB treatment, there was a significant improve in BMI, FFM and FM. The improvement was higher in FFM (p 0.05). Improvement in all parameters was significantly lower in patients with initially advanced lung disease (p=0.03). Conclusion: During the intensive phase of TB treatment patients with active pulmonary TB have significantly improved weight, FFM and FM. The improvement seems to be lower in men with advanced lung disease.