CONTEXT AND OBJECTIVE: The objective of the study was to assess the effects of HIV infection and antiretroviral therapy on change in bone mineral density (BMD) in postmenopausal minority women. DESIGN, SETTING, AND PATIENTS: We report a longitudinal analysis of change in BMD with a median duration of 15.4 (interquartile range 13.1, 20.7) months in a prospective cohort study of 128 (73 HIV+, 55 HIV-) postmenopausal Hispanic and African-American women. MAIN OUTCOME MEASURES: Annualized change in BMD by dual-energy x-ray absorptiometry and correlation with baseline markers of bone turnover and serum levels of inflammatory cytokines were measured. RESULTS: HIV+ women were younger (56 ± 1 vs. 59 ± 1 yr, P < 0.05) and had lower body mass index (BMI; 28 ± 1 vs. 31 ± 1 kg/m(2), P < 0.01). The majority of HIV+ women were on established antiretroviral therapy for more than 3 yr. At baseline, BMD, adjusted for age, race, and BMI, was lower in HIV+ women at the lumbar spine (LS), total hip, and radius and serum C-telopeptide was higher. Annualized rates of bone loss adjusted for baseline BMD were higher in HIV+ women by 2.4-fold at the LS (-1.2 ± 0.3% vs. -0.5 ± 0.3%, P = 0.0009), 3.7-fold at the one third radius (-1.1 ± 0.2% vs. -0.3 ± 0.2, P = 0.006) and 1.7-fold at the ultradistal radius (-1.2 ± 0.2% vs. -0.7 ± 0.2%, P = 0.02). In multivariate analysis, HIV+ status predicted bone loss at the LS, total hip, and ultradistal radius. Among HIV+ women, lower BMI, higher markers of bone turnover levels, and tenofovir were associated with more bone loss. CONCLUSION: HIV+ postmenopausal minority women had lower BMD, increased bone turnover, and higher rates of bone loss than HIV- women. These features may place these women at increased risk for fracture as they age.
CONTEXT AND OBJECTIVE: The objective of the study was to assess the effects of HIV infection and antiretroviral therapy on change in bone mineral density (BMD) in postmenopausal minority women. DESIGN, SETTING, AND PATIENTS: We report a longitudinal analysis of change in BMD with a median duration of 15.4 (interquartile range 13.1, 20.7) months in a prospective cohort study of 128 (73 HIV+, 55 HIV-) postmenopausal Hispanic and African-American women. MAIN OUTCOME MEASURES: Annualized change in BMD by dual-energy x-ray absorptiometry and correlation with baseline markers of bone turnover and serum levels of inflammatory cytokines were measured. RESULTS: HIV+ women were younger (56 ± 1 vs. 59 ± 1 yr, P < 0.05) and had lower body mass index (BMI; 28 ± 1 vs. 31 ± 1 kg/m(2), P < 0.01). The majority of HIV+ women were on established antiretroviral therapy for more than 3 yr. At baseline, BMD, adjusted for age, race, and BMI, was lower in HIV+ women at the lumbar spine (LS), total hip, and radius and serum C-telopeptide was higher. Annualized rates of bone loss adjusted for baseline BMD were higher in HIV+ women by 2.4-fold at the LS (-1.2 ± 0.3% vs. -0.5 ± 0.3%, P = 0.0009), 3.7-fold at the one third radius (-1.1 ± 0.2% vs. -0.3 ± 0.2, P = 0.006) and 1.7-fold at the ultradistal radius (-1.2 ± 0.2% vs. -0.7 ± 0.2%, P = 0.02). In multivariate analysis, HIV+ status predicted bone loss at the LS, total hip, and ultradistal radius. Among HIV+ women, lower BMI, higher markers of bone turnover levels, and tenofovir were associated with more bone loss. CONCLUSION: HIV+ postmenopausal minority women had lower BMD, increased bone turnover, and higher rates of bone loss than HIV- women. These features may place these women at increased risk for fracture as they age.
Authors: E M Stein; M T Yin; D J McMahon; A Shu; C A Zhang; D C Ferris; I Colon; J F Dobkin; S M Hammer; E Shane Journal: Osteoporos Int Date: 2010-06-29 Impact factor: 4.507
Authors: Sara E Dolan; Walter Frontera; Jamie Librizzi; Karin Ljungquist; Sandra Juan; Robert Dorman; Morgan E Cole; Jenna R Kanter; Steven Grinspoon Journal: Arch Intern Med Date: 2006-06-12
Authors: Julia H Arnsten; Ruth Freeman; Andrea A Howard; Michelle Floris-Moore; Yungtai Lo; Robert S Klein Journal: AIDS Date: 2007-03-12 Impact factor: 4.177
Authors: Michael T Yin; Don J McMahon; David C Ferris; Chiyuan A Zhang; Aimee Shu; Ronald Staron; Ivelisse Colon; Jeffrey Laurence; Jay F Dobkin; Scott M Hammer; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2009-12-04 Impact factor: 5.958
Authors: Julia H Arnsten; Ruth Freeman; Andrea A Howard; Michelle Floris-Moore; Nanette Santoro; Ellie E Schoenbaum Journal: Clin Infect Dis Date: 2006-02-24 Impact factor: 9.079
Authors: Joseph L Goulet; Shawn L Fultz; David Rimland; Adeel Butt; Cynthia Gibert; Maria Rodriguez-Barradas; Kendall Bryant; Amy C Justice Journal: Clin Infect Dis Date: 2007-12-15 Impact factor: 9.079
Authors: Todd T Brown; Grace A McComsey; Martin S King; Roula B Qaqish; Barry M Bernstein; Barbara A da Silva Journal: J Acquir Immune Defic Syndr Date: 2009-08-15 Impact factor: 3.771
Authors: Marcella D Walker; X Sherry Liu; Bin Zhou; Shivani Agarwal; George Liu; Donald J McMahon; John P Bilezikian; X Edward Guo Journal: J Bone Miner Res Date: 2013-06 Impact factor: 6.741
Authors: Julie A Womack; Joseph L Goulet; Cynthia Gibert; Cynthia A Brandt; Melissa Skanderson; Barbara Gulanski; David Rimland; Maria C Rodriguez-Barradas; Janet Tate; Michael T Yin; Amy C Justice Journal: Clin Infect Dis Date: 2013-02-01 Impact factor: 9.079
Authors: Yamnia I Cortés; Nancy Reame; Cosmina Zeana; Haomiao Jia; David C Ferris; Elizabeth Shane; Michael T Yin Journal: J Womens Health (Larchmt) Date: 2016-09-09 Impact factor: 2.681