Rodovia Araraquara - Jaú Km 1, Cep: 14801-902, Araraquara, SP, Brazil.
Bone. 2013 Nov;57(1):62-7. doi: 10.1016/j.bone.2013.07.019. Epub 2013 Jul 25.
To evaluate the impact of antiretroviral therapy (ART) on bone and mineral metabolism and to determine the occurrence of osteopenia and/or osteoporosis in HIV-infected patients taking ART or not.
A cross-sectional study was conducted on 50 HIV-seropositive adult men treated with or not treated with ART. Dual energy X-ray absorptiometry (DXA) was performed and biochemical analyses of the following markers were carried out: FSH, LH, testosterone, total calcium, phosphorus (Pi), magnesium (Mg), albumin, 24h calcium, creatinine, urea, parathormone (PTH), insulin-like growth factor 1 (IGF-I), 25 hydroxyvitamin D (25-OH-D), osteocalcin, and urinary deoxypyridinoline (DPD). The participants were divided into two groups according to ART use or not: Group A, 10 treatment-naive subjects; Group B, ART use for >2years, subdivided into: Group B1, 10 subjects treated with protease inhibitors (PIs) and nucleoside/nucleotide analog reverse transcriptase inhibitors (NRTIs) and Group B2, 10 subjects treated with NRTIs and non-nucleoside analog reverse transcriptase inhibitors (NNRTIs); and Group C, subjects treated with ART <2years, subdivided into: Group C1, 10 subjects treated with PIs and NRTIs and Group C2, 10 subjects treated with NRTIs and NNRTIs.
The values of the bone formation marker, osteocalcin, were normal in all groups, whereas urinary DPD values were increased in all groups. Whole body DXA revealed a higher percentage of osteopenia (80%) in Group B2. Lumbar spine DXA showed osteoporosis in Groups A and B1 (10%) and total femur DXA in Group B2 (10%).
The increased bone reabsorption marker indicated a high reabsorptive activity of bone tissue. These data indicate a greater osteoclastic activity in bone loss in HIV-infected patients on ART.
评估抗逆转录病毒疗法（ART）对骨和矿物质代谢的影响，并确定接受或未接受 ART 治疗的 HIV 感染患者中是否出现骨量减少和/或骨质疏松症。
对 50 名接受或未接受 ART 治疗的 HIV 阳性成年男性进行了一项横断面研究。进行双能 X 线吸收法（DXA）检查，并进行以下标记物的生化分析：FSH、LH、睾酮、总钙、磷（Pi）、镁（Mg）、白蛋白、24 小时钙、肌酐、尿素、甲状旁腺激素（PTH）、胰岛素样生长因子 1（IGF-1）、25 羟维生素 D（25-OH-D）、骨钙素和尿脱氧吡啶啉（DPD）。根据是否使用 ART 将参与者分为两组：A 组，10 名未经治疗的初治患者；B 组，使用 ART >2 年，分为：B1 组，10 名接受蛋白酶抑制剂（PI）和核苷/核苷酸逆转录酶抑制剂（NRTI）治疗的患者；B2 组，10 名接受 NRTI 和非核苷逆转录酶抑制剂（NNRTI）治疗的患者；C 组，使用 ART <2 年的患者，分为：C1 组，10 名接受 PI 和 NRTI 治疗的患者；C2 组，10 名接受 NRTI 和 NNRTI 治疗的患者。
所有组的骨形成标志物骨钙素值正常，而所有组的尿 DPD 值均升高。全身 DXA 显示 B2 组的骨量减少（80%）比例更高。腰椎 DXA 在 A 组和 B1 组（10%）和全股骨 DXA 在 B2 组（10%）显示骨质疏松症。
增加的骨吸收标志物表明骨组织的吸收活性较高。这些数据表明，接受 ART 治疗的 HIV 感染患者的骨质流失中破骨细胞活性更高。
