Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Osteoporos Int. 2012 Jun;23(6):1779-87. doi: 10.1007/s00198-011-1769-9. Epub 2011 Sep 8.
People with both HIV and hepatitis C are more likely than those with HIV alone to have wrist, hip, and spine fractures. We compared hip strength between HIV/HCV-co-infected men and healthy men and found that HIV/HCV-co-infected men had decreased hip strength due to lower lean body mass.
Hepatitis C co-infection is a risk factor for fragility fracture among HIV-infected populations. Whether bone strength is compromised in HIV/HCV-co-infected patients is unknown.
We compared dual-energy x-ray absorptiometry (DXA)-derived hip geometry, a measure of bone strength, in 88 HIV/HCV-co-infected men from the Johns Hopkins HIV Clinic to 289 men of similar age and race and without HIV or HCV from the Boston Area Community Health Survey/Bone Survey. Hip geometry was assessed at the narrow neck, intertrochanter, and shaft using hip structural analysis. Lean body mass (LBM), total fat mass (FM), and fat mass ratio (FMR) were measured by whole-body DXA. Linear regression was used to identify body composition parameters that accounted for differences in bone strength between cohorts.
HIV/HCV-co-infected men had lower BMI, LBM, and FM and higher FMR compared to controls (all p < 0.05). At the narrow neck, significant differences were observed between HIV/HCV-co-infected men and controls in bone mineral density, cross-sectional area, section modulus, buckling ratio, and centroid position. After adjustment for race, age, smoking status, height, and weight, only buckling ratio and centroid position remained significantly different between cohorts (all p < 0.05). Substituting LBM, FM, and FMR for weight in the multivariate model revealed that differences in LBM, but not FM or FMR, accounted for differences in all narrow neck parameters between cohorts, except buckling ratio and centroid position.
HIV/HCV-co-infected men have compromised hip strength at the narrow neck compared to uninfected controls, which is attributable in large part to lower lean body mass.
患有 HIV 和丙型肝炎的人比仅患有 HIV 的人更有可能手腕、臀部和脊柱骨折。我们比较了 HIV/HCV 合并感染男性和健康男性的臀部力量，发现 HIV/HCV 合并感染男性由于瘦体重较低而导致臀部力量下降。
丙型肝炎合并感染是 HIV 感染者脆性骨折的一个危险因素。HIV/HCV 合并感染患者的骨强度是否受损尚不清楚。
我们比较了来自约翰霍普金斯 HIV 诊所的 88 名 HIV/HCV 合并感染男性和来自波士顿地区社区健康调查/骨骼调查的 289 名年龄和种族相似且无 HIV 或 HCV 的男性的双能 X 线吸收法（DXA）衍生的髋部几何形状，这是衡量骨强度的一种方法。使用髋部结构分析在狭窄的颈部、转子间和轴处评估髋部几何形状。通过全身 DXA 测量瘦体重（LBM）、总脂肪量（FM）和脂肪质量比（FMR）。线性回归用于确定解释两组间骨强度差异的身体成分参数。
与对照组相比，HIV/HCV 合并感染男性的 BMI、LBM 和 FM 较低，FMR 较高（均 P<0.05）。在狭窄颈部，HIV/HCV 合并感染男性与对照组之间在骨密度、横截面积、截面模量、屈曲比和质心位置方面存在显著差异。在调整种族、年龄、吸烟状况、身高和体重后，仅在队列之间的屈曲比和质心位置仍存在显著差异（均 P<0.05）。在用 LBM、FM 和 FMR 代替体重进行多元模型后，除了屈曲比和质心位置外，LBM 但不是 FM 或 FMR 的差异解释了两组之间所有狭窄颈部参数的差异。
与未感染对照组相比，HIV/HCV 合并感染男性的狭窄颈部髋部力量较弱，这主要归因于瘦体重较低。
