Service de rhumatologie, CHU Lille, 59000 Lille, France; Université de Lille, université Littoral Côte d'Opale, PMOI EA 4490 faculté de chirurgie dentaire, place de Verdun, 59000 Lille, France.
Service des maladies infectieuses, centre hospitalier Tourcoing, CHU Lille, 59000 Lille, France.
Med Mal Infect. 2018 Oct;48(7):442-448. doi: 10.1016/j.medmal.2018.02.009. Epub 2018 Apr 23.
We aimed to investigate the prevalence of low bone mineral density (BMD) and associated factors in antiretroviral therapy (ART)-naive HIV-infected young men.
In this cross-sectional study, dual-energy X-ray absorptiometry (DXA) was used to measure BMD. BMD at the lumbar spine, total hip and femoral neck sites was expressed as a Z-score (number of standard deviations away from the mean in an age, race and sex-matched reference population). Low BMD was defined as Z-scores≤-2 at any of the three sites. The prevalence of low BMD was evaluated at the lumbar spine, total hip and femoral neck sites, as were risk factors associated with Z-scores.
The study cohort comprised 49 men, of whom 87.8% were white. Mean age was 31.6 (±7.7) years and mean BMI was 22.7 (±4.0)kg/m. Half of patients (51.0%) were current smokers. The prevalence of low BMD was 24.5% [95% CI, 13.3-38.9]. Low estradiol levels and low BMI were associated with low Z-scores at each skeletal site, whereas current smoking and high IGF1 levels were associated with low Z-scores at the lumbar spine site. Among the HIV-related factors, low CD4+ cell count was associated with low Z-scores at the lumbar spine site.
We observed a high prevalence of low BMD in our ART-naive cohort of young men. Risk factors associated with low Z-scores were those usually observed in HIV-infected individuals (low BMI, current smoking and CD4+ cell count) or linked to endocrine hormone levels (estradiol, IGF-1).
我们旨在研究初治 HIV 感染年轻男性的低骨密度（BMD）患病率及其相关因素。
在这项横断面研究中，采用双能 X 线吸收法（DXA）测量 BMD。腰椎、全髋和股骨颈部位的 BMD 以 Z 评分（与年龄、种族和性别匹配的参考人群平均值相差的标准差数）表示。任何部位的 Z 评分≤-2 定义为低 BMD。评估腰椎、全髋和股骨颈部位的低 BMD 患病率以及与 Z 评分相关的危险因素。
研究队列包括 49 名男性，其中 87.8%为白人。平均年龄为 31.6（±7.7）岁，平均 BMI 为 22.7（±4.0）kg/m2。半数患者（51.0%）为当前吸烟者。低 BMD 的患病率为 24.5%[95%CI，13.3-38.9]。低雌二醇水平和低 BMI 与各骨骼部位的低 Z 评分相关，而当前吸烟和高 IGF1 水平与腰椎部位的低 Z 评分相关。在 HIV 相关因素中，低 CD4+细胞计数与腰椎部位的低 Z 评分相关。
我们观察到我们的初治年轻男性队列中低 BMD 的患病率较高。与低 Z 评分相关的危险因素是 HIV 感染者中通常观察到的那些（低 BMI、当前吸烟和 CD4+细胞计数）或与内分泌激素水平相关的因素（雌二醇、IGF-1）。
