*Lluita Contra la Sida Foundation, Internal Medicine Department, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Barcelona, Spain; †Internal Medicine Department, Hospital Sant Pau, Barcelona, Spain; ‡Internal Medicine Department, Hospital Bellvitge, Barcelona, Spain; §Internal Medicine Department, Hospital Clínico San Carlos, Madrid, Spain; ‖Internal Medicine Department, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; ¶CETIR, Grup Mèdic, Barcelona, Spain; #Statistics and Operations Research, Technical University of Catalunya, Barcelona, Spain; and **Irsicaixa Foundation, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Barcelona, Spain.
J Acquir Immune Defic Syndr. 2014 Feb 1;65(2):207-12. doi: 10.1097/01.qai.0000435598.20104.d6.
Peak bone mass (PBM) is the amount of bone present at the end of skeletal maturation. It is an important determinant of osteoporotic fracture risk. Data on the PBM in the HIV-infected population are lacking.
We performed a multicenter (6 centers in Spain), case-control study to assess PBM using dual-energy x-ray absorptiometry. We studied HIV-infected patients aged 20-30 years and compared them with age- and gender-matched non-HIV-infected controls. We also assessed the predictive factors for a low PBM.
We included 307 subjects: 232 HIV-infected patients and 75 non-HIV-infected controls. Bone mineral density was similar in both groups although differences were seen in the total femur T-score (-0.15SD versus +0.50SD, respectively, P = 0.018). The percentage of osteopenia and osteoporosis was higher in the HIV-infected patients (56.5% and 10.7%, respectively) than in the controls (50.7% and 4%, respectively; P = 0.019). Osteoporosis was more frequent in HIV-infected men than in control men and HIV-infected women (12.2% versus 5.5% and 4.8%, P = 0.033). Protease inhibitors and nadir CD4 T-cells were negatively associated with PBM, whereas fat and lean mass were positively associated with PBM.
Bone mineral density was similar between HIV-infected patients aged 20-30 years than in age- and gender-matched controls. However, lower femoral T-scores and higher rate of osteopenia and osteoporosis were seen in HIV-infected men. Therapy with protease inhibitors, nadir CD4 counts, and fat and lean mass were predictive factors of PBM. Given that these patients will be living with HIV infection for many years, every effort should be made to modify risk factors.
峰值骨量（PBM）是骨骼成熟末期存在的骨量。它是骨质疏松性骨折风险的重要决定因素。缺乏关于 HIV 感染者群体中 PBM 的数据。
我们进行了一项多中心（西班牙 6 个中心）病例对照研究，使用双能 X 线吸收法评估 PBM。我们研究了年龄在 20-30 岁的 HIV 感染者，并将他们与年龄和性别匹配的非 HIV 感染者对照组进行了比较。我们还评估了低 PBM 的预测因素。
我们纳入了 307 名受试者：232 名 HIV 感染者和 75 名非 HIV 感染者对照组。两组的骨矿物质密度相似，但全股骨 T 评分存在差异（分别为-0.15SD 和+0.50SD，P=0.018）。HIV 感染者中骨质疏松症和骨质疏松症的比例高于对照组（分别为 56.5%和 10.7%，而对照组分别为 50.7%和 4%，P=0.019）。与对照组男性相比，HIV 感染者男性中骨质疏松症更为常见（12.2%比 5.5%和 4.8%，P=0.033）。蛋白酶抑制剂和 CD4 细胞最低点与 PBM 呈负相关，而脂肪和瘦体重与 PBM 呈正相关。
20-30 岁的 HIV 感染者与年龄和性别匹配的对照组相比，骨矿物质密度相似。然而，HIV 感染者男性的股骨 T 评分较低，骨质疏松症和骨质疏松症的发生率较高。蛋白酶抑制剂治疗、CD4 细胞最低点、脂肪和瘦体重是 PBM 的预测因素。鉴于这些患者将长期感染 HIV，应尽一切努力改变风险因素。
