Yin Michael T, Lund Emily, Shah Jayesh, Zhang Chiyuan A, Foca Marc, Neu Natalie, Nishiyama Kyle K, Zhou Bin, Guo Xiangdong E, Nelson John, Bell David L, Shane Elizabeth, Arpadi Stephen M
aColumbia University Medical Center bBone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York, USA.
AIDS. 2014 Jan 28;28(3):345-53. doi: 10.1097/QAD.0000000000000070.
HIV infection and antiretroviral therapy (ART) early in life may interfere with acquisition of peak bone mass, thereby increasing fracture risk in adulthood.
We conducted a cross-sectional study of dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) in 30 HIV-infected African-American or Hispanic Tanner stage 5 men aged 20-25 on ART (15 perinatally infected and 15 infected during adolescence) and 15 HIV-uninfected controls.
HIV-infected men were similar in age and BMI, but were more likely to be African-American (P = 0.01) than uninfected men. DXA-derived areal bone mineral density (aBMD) Z-scores were 0.4-1.2 lower in HIV-infected men at the spine, hip, and radius (all P < 0.05). At the radius and tibia, total and trabecular volumetric BMD (vBMD), and cortical and trabecular thickness were between 6 and 19% lower in HIV-infected than uninfected men (P <0.05). HIV-infected men had dramatic deficiencies in plate-related parameters by individual trabeculae segmentation (ITS) analyses and 14-17% lower bone stiffness by finite element analysis. Differences in most HR-pQCT parameters remained significant after adjustment for race/ethnicity. No DXA or HR-pQCT parameters differed between men infected perinatally or during adolescence.
At an age by which young men have typically acquired peak bone mass, HIV-infected men on ART have lower BMD, markedly abnormal trabecular plate and cortical microarchitecture, and decreased whole bone stiffness, whether infected perinatally or during adolescence. Reduced bone strength in young adults infected with HIV early in life may place them at higher risk for fractures as they age.
生命早期的HIV感染和抗逆转录病毒疗法（ART）可能会干扰峰值骨量的获取，从而增加成年期骨折风险。
我们对30名接受ART治疗的20 - 25岁处于坦纳5期的HIV感染非裔美国或西班牙裔男性（15名围产期感染，15名青春期感染）以及15名未感染HIV的对照者进行了双能X线吸收法（DXA）和高分辨率外周定量计算机断层扫描（HR - pQCT）的横断面研究。
HIV感染男性在年龄和体重指数方面相似，但与未感染男性相比，更有可能是非裔美国人（P = 0.01）。HIV感染男性在脊柱、髋部和桡骨处，通过DXA得出的面积骨密度（aBMD）Z分数低0.4 - 1.2（所有P < 0.05）。在桡骨和胫骨处，HIV感染男性的总体积骨密度（vBMD）和小梁体积骨密度、皮质厚度和小梁厚度比未感染男性低6%至19%（P < 0.05）。通过个体小梁分割（ITS）分析，HIV感染男性在与骨板相关的参数方面存在显著缺陷，通过有限元分析，骨刚度低14% - 17%。在调整种族/族裔因素后，大多数HR - pQCT参数的差异仍然显著。围产期感染或青春期感染的男性之间，DXA或HR - pQCT参数没有差异。
在年轻男性通常已获得峰值骨量的年龄，接受ART治疗的HIV感染男性骨密度较低，小梁骨板和皮质微结构明显异常，全骨刚度降低，无论其是围产期感染还是青春期感染。生命早期感染HIV的年轻成年人骨强度降低，随着年龄增长，他们骨折的风险可能更高。
