Relationship of Acute Phase Reactants and Fat Accumulation during Treatment for Tuberculosis

Abstract

Background. Tuberculosis causes inflammation and muscle wasting. We investigated how attenuation of inflammation relates to repletion of body composition during treatment in an underserved population. Design. Twenty-four patients (23 to 79 years old) with pulmonary tuberculosis and inflammation (pretreatment albumin =2.96±0.13 g/dL, C-reactive protein [CRP] =6.71±1.34 μg/dL, and beta-2-microglobulin =1.68±0.10 μg/L) were evaluated and had BIA over 24 weeks. Results. Weight increased by 3.02±0.81 kg (5.5%; 𝑃=0.007) at week 4 and by 8.59±0.97 kg (15.6%; 𝑃<0.0001) at week 24. Repletion of body mass was primarily fat, which increased by 2.09±0.52 kg at week 4 and 5.05±0.56 kg at week 24 (𝑃=0.004 and 𝑃<0.0001 versus baseline). Fat-free mass (FFM), body cell mass (BCM), and phase angle did not increase until study week 8. Albumin rose to 3.65±0.14 g/dL by week 4 (𝑃<0.001) and slowly increased thereafter. CRP levels declined by ~50% at each interval visit. Conclusions. During the initial treatment, acute phase reactants returned towards normal. The predominant accrual of fat mass probably reflects ongoing, low levels of inflammation.