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Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia : A Novel Context for Refeeding Syndrome?
Joint Authors
Chiasera, Janelle M.
Blevins, Meridith
Kabagambe, Edmond K.
Nyirenda, Christopher K.
Koethe, John R.
Zulu, Isaac
Shepherd, Bryan E.
Heimburger, Douglas C.
Source
Journal of Nutrition and Metabolism
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-04-16
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Low body mass index (BMI) at antiretroviral therapy (ART) initiation is associated with early mortality, but the etiology is not well understood.
We hypothesized that low pretreatment serum phosphate, a critical cellular metabolism intermediate primarily stored in skeletal muscle, may predict mortality within the first 12 weeks of ART.
Methods.
We prospectively studied 352 HIV-infected adults initiating ART in Lusaka, Zambia to estimate the odds of death for each 0.1 mmol/L decrease in baseline phosphate after adjusting for established predictors of mortality.
Results.
The distribution of phosphate values was similar across BMI categories (median value 1.2 mmol/L).
Among the 145 participants with BMI <18.5 kg/m2, 28 (19%) died within 12 weeks.
Lower pretreatment serum phosphate was associated with increased mortality (odds ratio (OR) 1.24 per 0.1 mmol/L decrement, 95% CI: 1.05 to 1.47; P=0.01) after adjusting for sex, age, and CD4+ lymphocyte count.
A similar relationship was not observed among participants with BMI ≥18.5 kg/m2 (OR 0.96, 95% CI: 0.76 to 1.21; P=0.74).
Conclusions.
The association of low pretreatment serum phosphate level and early ART mortality among undernourished individuals may represent a variant of the refeeding syndrome.
Further studies of cellular metabolism in this population are needed.
American Psychological Association (APA)
Koethe, John R.& Blevins, Meridith& Nyirenda, Christopher K.& Kabagambe, Edmond K.& Chiasera, Janelle M.& Shepherd, Bryan E.…[et al.]. 2013. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia : A Novel Context for Refeeding Syndrome?. Journal of Nutrition and Metabolism،Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-480296
Modern Language Association (MLA)
Koethe, John R.…[et al.]. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia : A Novel Context for Refeeding Syndrome?. Journal of Nutrition and Metabolism No. 2013 (2013), pp.1-6.
https://search.emarefa.net/detail/BIM-480296
American Medical Association (AMA)
Koethe, John R.& Blevins, Meridith& Nyirenda, Christopher K.& Kabagambe, Edmond K.& Chiasera, Janelle M.& Shepherd, Bryan E.…[et al.]. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia : A Novel Context for Refeeding Syndrome?. Journal of Nutrition and Metabolism. 2013. Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-480296
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-480296