Juliana Mendes Abreu1, Amanda B B Nogueira2, Mariana M Villela2, Denise M Módolo3, Thaís C Panaro3, Sérgio Setubal4, Luiz Guillermo C Velarde5, Giovanna A B Lima4, Rubens A da Cruz Filho4, Debora V Soares4. 1. Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil. jmabreu@id.uff.br. 2. Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil. 3. Scientific Initiation Program of the Medical Graduation Course, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil. 4. Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil. 5. Department of Statistics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
Abstract
We performed a cross-sectional study in 212 PLHIV under antiretroviral therapy. Bone mass was compromised in 36.5% of relatively young sample and associated with hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was present in 85%, especially those on NNRTI. PURPOSE: Previous studies have reported an increased prevalence of bone demineralization among people living with the human immunodeficiency virus (PLHIV). We aimed to assess bone mineral density (BMD), vitamin D levels, and associated risk factors in Brazilian PLHIV. METHODS: Cross-sectional study with 212 patients in a specialized assistance service. Clinical and demographic information were registered. Laboratory tests were performed, and BMD was measured at the lumbar spine, total hip/femoral neck, and forearm by dual-energy X-ray absorptiometry. Participants were classified into "with low bone mass (wLBM)" and "without low bone mass (woLBM)." Those wLBM encompasses osteoporosis, osteopenia, and below the expected range for age as recommended by the World Health Organization. RESULTS: One hundred and eighty-seven patients were included. Median age was 46.3 years (interquartile range (IQR) 40-52) and duration of HAART exposure was 11.2 years (IQR 7-15). Plasma viral load was undetectable in 79%. Hypovitaminosis D (< 30 ng/mL) was present in 85% and LBM in 36.5%. Men wLBM were more likely to have testosterone deficiency and had higher PTH levels than those woLBM. LBM in women was associated with older age, menopause, and metabolic syndrome. CONCLUSION: This study showed a high frequency of LBM in a relatively young sample, and suggests a detrimental effect of hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was frequent, especially those on non-nucleoside reverse transcriptase inhibitor, higher body mass index, and abdominal circumference.
We performed a cross-sectional study in 212 PLHIV under antiretroviral therapy. Bone mass was compromised in 36.5% of relatively young sample and associated with hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was present in 85%, especially those on NNRTI. PURPOSE: Previous studies have reported an increased prevalence of bone demineralization among people living with the human immunodeficiency virus (PLHIV). We aimed to assess bone mineral density (BMD), vitamin D levels, and associated risk factors in Brazilian PLHIV. METHODS: Cross-sectional study with 212 patients in a specialized assistance service. Clinical and demographic information were registered. Laboratory tests were performed, and BMD was measured at the lumbar spine, total hip/femoral neck, and forearm by dual-energy X-ray absorptiometry. Participants were classified into "with low bone mass (wLBM)" and "without low bone mass (woLBM)." Those wLBM encompasses osteoporosis, osteopenia, and below the expected range for age as recommended by the World Health Organization. RESULTS: One hundred and eighty-seven patients were included. Median age was 46.3 years (interquartile range (IQR) 40-52) and duration of HAART exposure was 11.2 years (IQR 7-15). Plasma viral load was undetectable in 79%. Hypovitaminosis D (< 30 ng/mL) was present in 85% and LBM in 36.5%. Men wLBM were more likely to have testosterone deficiency and had higher PTH levels than those woLBM. LBM in women was associated with older age, menopause, and metabolic syndrome. CONCLUSION: This study showed a high frequency of LBM in a relatively young sample, and suggests a detrimental effect of hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was frequent, especially those on non-nucleoside reverse transcriptase inhibitor, higher body mass index, and abdominal circumference.
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