Magda T Thomsen1, Yaffah L Wiegandt2, Marco Gelpi1, Andreas D Knudsen1,2, Andreas Fuchs2, Per E Sigvardsen2, Jørgen T Kühl2, Børge Nordestgaard3,4, Lars Køber2, Jens Lundgren5, Ann-Brit E Hansen6, Klaus F Kofoed7, Jens-Erik B Jensen8,9, Susanne D Nielsen1. 1. Viro-immonology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 2. Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 3. Department of Clinical Biochemistry, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. 4. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Department of Infectious Diseases, Rigshospitalet, CHIP, University of Copenhagen, Copenhagen, Denmark. 6. Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. 7. Department of Cardiology and Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 8. Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark; and. 9. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: Low bone mineral density (BMD) has been described in people living with HIV (PLWH). We examined the prevalence of low BMD measured by quantitative computed tomography (QCT), a method that allows 3-dimensional volumetric density measures at the thoracic spine, in well-treated PLWH and uninfected controls and assessed risk factors for reduced BMD. METHODS: Cross-sectional study including 718 PLWH from the Copenhagen Co-Morbidity in HIV infection (COCOMO) study and 718 uninfected controls matched on age and sex from the Copenhagen General Population Study (CGPS). Trabecular BMD was determined by QCT. RESULTS: Median BMD was 144.2 mg/cm in PLWH vs. 146.6 mg/cm in controls (P = 0.580). HIV status was not associated with BMD in univariable or multivariable linear analyses. However, a higher prevalence of very low BMD (T-score ≤ -2.5) was found in PLWH (17.2% vs. 11.0% in controls, P = 0.003). In unadjusted analysis, HIV was associated with very low BMD (odds ratio 1.68 [95% confidence interval: 1.24-2.27], P = 0.001), but this association was not significant after adjusting for age, sex, smoking, alcohol, body mass index, physical activity, and ethnicity. Previous AIDS-defining disease was associated with lower BMD, but no other associations with HIV-specific variables were identified. CONCLUSION: Using QCT, we found a higher prevalence of very low BMD in PLWH than in controls. However, HIV status was not independently associated with BMD indicating that traditional risk factors contribute to the difference in prevalence of very low BMD. Focus on improvement of lifestyle factors, especially in PLWH with previous AIDS-defining disease, may prevent very low BMD in PLWH.
BACKGROUND: Low bone mineral density (BMD) has been described in people living with HIV (PLWH). We examined the prevalence of low BMD measured by quantitative computed tomography (QCT), a method that allows 3-dimensional volumetric density measures at the thoracic spine, in well-treated PLWH and uninfected controls and assessed risk factors for reduced BMD. METHODS: Cross-sectional study including 718 PLWH from the Copenhagen Co-Morbidity in HIV infection (COCOMO) study and 718 uninfected controls matched on age and sex from the Copenhagen General Population Study (CGPS). Trabecular BMD was determined by QCT. RESULTS: Median BMD was 144.2 mg/cm in PLWH vs. 146.6 mg/cm in controls (P = 0.580). HIV status was not associated with BMD in univariable or multivariable linear analyses. However, a higher prevalence of very low BMD (T-score ≤ -2.5) was found in PLWH (17.2% vs. 11.0% in controls, P = 0.003). In unadjusted analysis, HIV was associated with very low BMD (odds ratio 1.68 [95% confidence interval: 1.24-2.27], P = 0.001), but this association was not significant after adjusting for age, sex, smoking, alcohol, body mass index, physical activity, and ethnicity. Previous AIDS-defining disease was associated with lower BMD, but no other associations with HIV-specific variables were identified. CONCLUSION: Using QCT, we found a higher prevalence of very low BMD in PLWH than in controls. However, HIV status was not independently associated with BMD indicating that traditional risk factors contribute to the difference in prevalence of very low BMD. Focus on improvement of lifestyle factors, especially in PLWH with previous AIDS-defining disease, may prevent very low BMD in PLWH.
Authors: J Carballido-Gamio; M Posadzy; P-H Wu; K Kenny; I Saeed; T M Link; P C Tien; R Krug; G J Kazakia Journal: Osteoporos Int Date: 2022-04-27 Impact factor: 5.071
Authors: Tingting Zhang; Ira B Wilson; Andrew R Zullo; David J Meyers; Yoojin Lee; Lori A Daiello; Dae Hyun Kim; Douglas P Kiel; Theresa I Shireman; Sarah D Berry Journal: J Am Med Dir Assoc Date: 2021-09-25 Impact factor: 7.802