Bolland Mark J, Grey Andrew B, Horne Anne M, Briggs Simon E, Thomas Mark G, Ellis-Pegler Rod B, Woodhouse Andrew F, Gamble Greg D, Reid Ian R
Department of Medicine, University of Auckland, Auckland, New Zealand.
Clin Endocrinol (Oxf). 2007 Aug;67(2):270-5. doi: 10.1111/j.1365-2265.2007.02875.x. Epub 2007 Jun 4.
Recently we reported that human immunodeficiency virus (HIV)-infected Caucasian men treated with highly active antiretroviral therapy (HAART) have normal weight-adjusted bone mineral density (BMD), in contrast to most other cross-sectional analyses, which have reported low BMD in HIV-infected patients. We have now addressed the question of whether there is accelerated BMD loss over time in HIV-infected men.
A 2-year, prospective, longitudinal study.
Twenty-three HAART-treated, HIV-infected men and 26 healthy controls.
All participants had measurements of BMD and bone-related laboratory parameters at baseline, and a repeat measurement of BMD at 2 years.
In the HIV-infected men the mean age was 47 years, the mean duration of infection was 8.2 years, and the mean duration of HAART was 54 months. Over 2 years of follow-up, BMD increased from baseline in the HIV-infected men by 2.6% at the lumbar spine (P = 0.05 vs. baseline), and remained stable at the total hip (mean change 0.1%, P > 0.99) and total body (mean change 0.6%, P = 0.39). Mean changes in BMD in the control group were 1.4% at the lumbar spine, -0.1% at the total hip, and -0.8% at the total body. The HIV-infected men lost less total body BMD than the control group (P = 0.01). In the HIV-infected men, body weight remained stable over 2 years while fat mass decreased and lean mass tended to increase, whereas in the controls, body weight and fat mass increased while lean mass remained stable.
Accelerated bone loss does not occur in HIV-infected men treated with HAART. Monitoring of BMD in HIV-infected men may not be necessary.
最近我们报告，接受高效抗逆转录病毒治疗（HAART）的人类免疫缺陷病毒（HIV）感染的白人男性具有正常的体重校正骨矿物质密度（BMD），这与大多数其他横断面分析不同，那些分析报告HIV感染患者的BMD较低。我们现在探讨了HIV感染男性随时间推移是否存在骨矿物质密度加速丢失的问题。
一项为期2年的前瞻性纵向研究。
23名接受HAART治疗的HIV感染男性和26名健康对照者。
所有参与者在基线时测量了骨矿物质密度和骨相关实验室参数，并在2年时重复测量了骨矿物质密度。
在HIV感染男性中，平均年龄为47岁，平均感染持续时间为8.2年，平均HAART治疗持续时间为54个月。在2年的随访中，HIV感染男性的腰椎骨矿物质密度较基线增加了2.6%（与基线相比，P = 0.05），全髋部保持稳定（平均变化0.1%，P > 0.99），全身平均变化0.6%（P = 0.39）。对照组的腰椎骨矿物质密度平均变化为1.4%，全髋部为-0.1%，全身为-0.8%。HIV感染男性的全身骨矿物质密度损失低于对照组（P = 0.01）。在HIV感染男性中，体重在2年内保持稳定，而脂肪量减少，瘦体重趋于增加，而在对照组中，体重和脂肪量增加，瘦体重保持稳定。
接受HAART治疗的HIV感染男性不会发生加速骨质流失。可能无需对HIV感染男性进行骨矿物质密度监测。
