Jacobson Denise L, Lindsey Jane C, Coull Brent A, Mulligan Kathleen, Bhagwat Priya, Aldrovandi Grace M
Pediatr Infect Dis J. 2018 Jan;37(1):71-77. doi: 10.1097/INF.0000000000001715.
HIV-infected (HIV-pos) male children/youth showed lower bone mineral density at sexual maturity than HIV-uninfected (HIV-neg) females. It is not known whether complications of HIV disease, including abnormal body fat distribution, contribute to lower bone accrual in male HIV-pos adolescents.
In a cross-sectional study, we evaluated the relationship between body composition (fat and lean mass) and bone mass in HIV-pos and HIV-neg children/youth and determined if it is modified by HIV status and sex. We used generalized estimating equations to simultaneously model the effect of fat/lean mass on multiple bone outcomes, including total body bone mineral density and bone mineral content and spine bone mineral density. We evaluated effect modification by HIV and sex.
The analysis cohort consisted of 143 HIV-neg and 236 HIV-pos, of whom 55% were black non-Hispanic and 53% were male. Ages ranged from 7 to < 25 years. Half of the children/youth were at Tanner stage 1 and 20% at Tanner 5. Fat mass was more strongly positively correlated with bone mass in HIV-neg than HIV-pos children/youth and these relationships were more evident for total body bone than spine outcomes. Within HIV strata, fat mass and bone were more correlated in female than male children/youth. The relationship between lean mass and bone varied by sex, but not by HIV status.
HIV disease diminishes the positive relationship of greater fat mass on bone mass in children/youth. Disruptions in body fat distribution, which are common in HIV disease, may have an impact on bone accretion during pubertal development.
感染人类免疫缺陷病毒（HIV）的男性儿童/青少年在性成熟时的骨密度低于未感染HIV的女性。目前尚不清楚HIV疾病的并发症，包括异常的身体脂肪分布，是否会导致感染HIV的男性青少年骨量增加减少。
在一项横断面研究中，我们评估了感染HIV和未感染HIV的儿童/青少年的身体成分（脂肪和瘦体重）与骨量之间的关系，并确定其是否因HIV状态和性别而有所改变。我们使用广义估计方程同时对脂肪/瘦体重对多种骨指标的影响进行建模，包括全身骨密度、骨矿物质含量和脊柱骨密度。我们评估了HIV和性别的效应修饰作用。
分析队列包括143名未感染HIV者和236名感染HIV者，其中55%为非西班牙裔黑人，53%为男性。年龄范围为7至<25岁。一半的儿童/青少年处于坦纳1期，20%处于坦纳5期。与感染HIV的儿童/青少年相比，未感染HIV的儿童/青少年中脂肪量与骨量的正相关性更强，并且这些关系在全身骨方面比脊柱指标更明显。在HIV分层中，女性儿童/青少年的脂肪量与骨量的相关性高于男性。瘦体重与骨量的关系因性别而异，但不因HIV状态而异。
HIV疾病削弱了儿童/青少年中较高脂肪量与骨量之间的正相关关系。HIV疾病中常见的身体脂肪分布紊乱可能会对青春期发育期间的骨生长产生影响。
