HIV Hastalarında Sarkopeni Sıklığı: Fonksiyonel Performans Üzerine Etkileri
Yıl 2026,
Cilt: 16 Sayı: 1, 107 - 114, 15.03.2026
Bora Uzuner
,
Erdal Hancı
,
Dilek Durmuş
,
Sertaç Ketenci
,
Muharrem Yüksel
,
Elifsu Beniç
,
Aydın Deveci
Öz
Amaç:
Bu çalışmanın amacı, İnsan İmmün Yetmezlik Virüsü (HIV) enfeksiyonu olan hastalarda sarkopeni prevalansını belirlemek ve sarkopeninin fonksiyonel performans üzerindeki etkisini değerlendirmektir.
Gereç ve Yöntem:
Çalışmaya 67 HIV hastası ve 50 sağlıklı kontrol dahil edildi. Sarkopeni değerlendirmesinde, ultrasonografi ile ölçülen bilateral rektus femoris ve vastus intermedius kas kalınlıklarının toplamına dayanan Modifiye Sonografik Uyluk Ayarlama Oranı (STAR) yöntemi kullanıldı. El kavrama kuvveti (HMS) dinamometre ile ölçüldü. Diz kas kuvveti (KMS) izokinetik kas testi ile değerlendirildi. Fiziksel performans; Timed Up-and-Go Testi (TUGT), 5 Tekrarlı Otur-Kalk Testi (5RSTS) ve 6 Dakika Yürüme Testi (6DYT) ile belirlendi.
Bulgular:
Vücut kitle indeksine göre düzeltilmiş STAR değerlerine göre, 57 erkek hastanın 10’unda (%17,5) sarkopeni saptandı. Kadın hastalarda sarkopeni tespit edilmedi. Gruplar arasında demografik özellikler açısından anlamlı fark yoktu. Ancak HMS, KMS, TUGT, 5RSTS ve 6DYT sonuçları açısından gruplar arasında anlamlı farklılık bulundu (p < 0,005).
Sonuç:
Bu çalışma, HIV ile yaşayan bireylerde, özellikle erkek hastalarda, sarkopeninin dikkate değer bir sıklıkta görüldüğünü ve kas gücü ile fonksiyonel performansta klinik olarak anlamlı azalmalarla ilişkili olduğunu göstermektedir. Ultrasonografi temelli Modifiye STAR skorunun, bu hasta grubunda bölgesel kas kaybını değerlendirmede pratik ve güvenilir bir yöntem olduğu görülmektedir.
Kaynakça
-
1. Roubenoff R. Acquired immunodeficiency syndrome wasting, functional performance, and quality of life. Am J Manag Care. 2000;6(9):1003-16.
-
2. Grant PM, Kitch D, McComsey GA, Collier AC, Bartali B, Koletar SL et al. Long-term body composition changes in antiretroviral-treated HIV-infected individuals. AIDS. 2016;30(18):2805-13.
-
3. Richert L, Dehail P, Mercié P, Dauchy FA, Bruyand M, Greib C et al; Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA). High frequency of poor locomotor performance in HIV-infected patients. AIDS. 2011;25(6):797-805.
-
4. Wasserman P, Segal-Maurer S, Rubin DS. High prevalence of low skeletal muscle mass associated with male gender in midlife and older HIV-infected persons despite CD4 cell reconstitution and viral suppression. J Int Assoc Provid AIDS Care. 2014;13(2):145-52.
-
5. Gomes-Neto M, Rodriguez I, Lédo AP, Vieira JPB, Brites C. Muscle Strength and Aerobic Capacity in HIV-Infected Patients: A Systematic Review and Meta-Analysis. J Acquir Immune Defic Syndr. 2018;79(4):491-500.
-
6. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
-
7. Perkisas S, Baudry S, Bauer J, Beckwée D, De Cock AM, Hobbelen H et al. Application of ultrasound for
muscle assessment in sarcopenia: towards standardized measurements. Eur Geriatr Med. 2018;9(6):739-57.
-
8. Abdul Aziz SA, Mcstea M, Ahmad Bashah NS, Chong ML, Ponnampalavanar S, Syed Omar SF et al. Assessment of sarcopenia in virally suppressed HIV-infected Asians receiving treatment. AIDS. 2018;32(8):1025-34.
-
9. Echeverría P, Bonjoch A, Puig J, Estany C, Ornelas A, Clotet B et al. High Prevalence of Sarcopenia in HIV-Infected Individuals. Biomed Res Int. 2018;2018:5074923.
-
10. Kara M, Kaymak B, Ata AM, Özkal Ö, Kara Ö, Baki A et al. STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia. Am J Phys Med Rehabil. 2020;99(10):902-8.
-
11. Şekir U, Arabacı R, Akova B. Acute effects of dynamic stretching on peak and end-range functional hamstring/quadriceps strength ratios. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2010;30(1),164-73.
-
12. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23.
-
13. Painter P, Stewart AL, Carey S. Physical functioning: definitions, measurement, and expectations. Adv Ren Replace Ther. 1999;6(2):110-23.
-
14. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-7.
-
15. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
-
16. Oliveira VHF, Borsari AL, Webel AR, Erlandson KM, Deminice R. Sarcopenia in people living with the Human Immunodeficiency Virus: a systematic review and meta-analysis. Eur J Clin Nutr. 2020;74(7):1009-21.
-
17. Uzuner B, Ketenci S, Durmus D, Atay HM. The frequency of sarcopenia in haemophilia patients: Effects on musculoskeletal health and functional performance. Haemophilia. 2024;30(2):505-12.
-
18. Erlandson KM, Schrack JA, Jankowski CM, Brown TT, Campbell TB. Functional impairment, disability, and frailty in adults aging with HIV-infection. Curr HIV/AIDS Rep. 2014;11(3):279-90.
The frequency of sarcopenia in HIV patients: Effects on functional performance
Yıl 2026,
Cilt: 16 Sayı: 1, 107 - 114, 15.03.2026
Bora Uzuner
,
Erdal Hancı
,
Dilek Durmuş
,
Sertaç Ketenci
,
Muharrem Yüksel
,
Elifsu Beniç
,
Aydın Deveci
Öz
Aim: The present study aims to determine the prevalence of sarcopenia in Human Immunodeficiency Virus Infection (HIV) patients and to evaluate functional performance.
Material and Methods: 67 patients with HIV and 50 healthy control were included in the study. For detection for sarcopenia, the thighs of both lower extremities were measured using the Modified Sonographic Tight Adjustment Ratio (STAR) method, which was obtained by adding the bilateral rectus femoris and vastus intermedius muscle thicknesses measured by ultrasound. Hand muscle strength (HMS) was measured with a dynamometer. Knee Muscle strength (KMS) was measured isokinetic muscle testing. Physical performance was determined using timed up-and-go test (TUGT), 5-repetition sit-to-stand test (5RSTS), and 6-min walk test (6MWT).
Results:
According to the STAR values calculated based on body mass index, sarcopenia was present in 10 (17.5%) of 57 male patients. Sarcopenia was not detected in female patients. There was no significant difference with respect to demographic characteristics among the two groups. HMS, KMS, TUGT, 5RSTS and 6MWT values were significantly different in two groups (p<0.005)
Conclusions:
This study confirms a significant prevalence of sarcopenia among people living with HIV, particularly in male patients, and demonstrates its association with clinically meaningful declines in muscle strength and functional performance. The use of the ultrasonography-based Modified STAR score provided a reliable and practical method for assessing region-specific muscle loss, offering a valuable diagnostic tool in this population
Etik Beyan
Clinical Research Ethics Committee of Ondokuz Mayis University (no: 2022/175).
Destekleyen Kurum
The authors declare that they have no known competing financial or personal interests that could have influenced the work reported in this paper.
Teşekkür
Author's covering letter for initial submission
Title: The frequency of sarcopenia in HIV patients: Effects on functional performance
Dear Editor,
We are pleased to submit our "Research Article" entitled " The frequency of sarcopenia in HIV patients: Effects on functional performance " for your consideration for publication in Bozok Medicine journal. Our manuscript has not been published elsewhere, and if accepted in Bozok Medicine journal. We will not be republished in any other journal in the same or similar form, without the written consent of the Editor of Bozok Medicine journal. We declare no financial or other relationships leading to a conflict of interest. The manuscript has been read and approved by all authors.
Sincerely
Corresponding author:
Bora Uzuner, M.D
1Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
Tel.: +90 5304162566
Kaynakça
-
1. Roubenoff R. Acquired immunodeficiency syndrome wasting, functional performance, and quality of life. Am J Manag Care. 2000;6(9):1003-16.
-
2. Grant PM, Kitch D, McComsey GA, Collier AC, Bartali B, Koletar SL et al. Long-term body composition changes in antiretroviral-treated HIV-infected individuals. AIDS. 2016;30(18):2805-13.
-
3. Richert L, Dehail P, Mercié P, Dauchy FA, Bruyand M, Greib C et al; Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA). High frequency of poor locomotor performance in HIV-infected patients. AIDS. 2011;25(6):797-805.
-
4. Wasserman P, Segal-Maurer S, Rubin DS. High prevalence of low skeletal muscle mass associated with male gender in midlife and older HIV-infected persons despite CD4 cell reconstitution and viral suppression. J Int Assoc Provid AIDS Care. 2014;13(2):145-52.
-
5. Gomes-Neto M, Rodriguez I, Lédo AP, Vieira JPB, Brites C. Muscle Strength and Aerobic Capacity in HIV-Infected Patients: A Systematic Review and Meta-Analysis. J Acquir Immune Defic Syndr. 2018;79(4):491-500.
-
6. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
-
7. Perkisas S, Baudry S, Bauer J, Beckwée D, De Cock AM, Hobbelen H et al. Application of ultrasound for
muscle assessment in sarcopenia: towards standardized measurements. Eur Geriatr Med. 2018;9(6):739-57.
-
8. Abdul Aziz SA, Mcstea M, Ahmad Bashah NS, Chong ML, Ponnampalavanar S, Syed Omar SF et al. Assessment of sarcopenia in virally suppressed HIV-infected Asians receiving treatment. AIDS. 2018;32(8):1025-34.
-
9. Echeverría P, Bonjoch A, Puig J, Estany C, Ornelas A, Clotet B et al. High Prevalence of Sarcopenia in HIV-Infected Individuals. Biomed Res Int. 2018;2018:5074923.
-
10. Kara M, Kaymak B, Ata AM, Özkal Ö, Kara Ö, Baki A et al. STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia. Am J Phys Med Rehabil. 2020;99(10):902-8.
-
11. Şekir U, Arabacı R, Akova B. Acute effects of dynamic stretching on peak and end-range functional hamstring/quadriceps strength ratios. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2010;30(1),164-73.
-
12. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23.
-
13. Painter P, Stewart AL, Carey S. Physical functioning: definitions, measurement, and expectations. Adv Ren Replace Ther. 1999;6(2):110-23.
-
14. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-7.
-
15. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
-
16. Oliveira VHF, Borsari AL, Webel AR, Erlandson KM, Deminice R. Sarcopenia in people living with the Human Immunodeficiency Virus: a systematic review and meta-analysis. Eur J Clin Nutr. 2020;74(7):1009-21.
-
17. Uzuner B, Ketenci S, Durmus D, Atay HM. The frequency of sarcopenia in haemophilia patients: Effects on musculoskeletal health and functional performance. Haemophilia. 2024;30(2):505-12.
-
18. Erlandson KM, Schrack JA, Jankowski CM, Brown TT, Campbell TB. Functional impairment, disability, and frailty in adults aging with HIV-infection. Curr HIV/AIDS Rep. 2014;11(3):279-90.