Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil.
Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
Arch Osteoporos. 2022 Mar 5;17(1):40. doi: 10.1007/s11657-022-01088-8.
We performed a cross-sectional study in 212 PLHIV under antiretroviral therapy. Bone mass was compromised in 36.5% of relatively young sample and associated with hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was present in 85%, especially those on NNRTI.
Previous studies have reported an increased prevalence of bone demineralization among people living with the human immunodeficiency virus (PLHIV). We aimed to assess bone mineral density (BMD), vitamin D levels, and associated risk factors in Brazilian PLHIV.
Cross-sectional study with 212 patients in a specialized assistance service. Clinical and demographic information were registered. Laboratory tests were performed, and BMD was measured at the lumbar spine, total hip/femoral neck, and forearm by dual-energy X-ray absorptiometry. Participants were classified into "with low bone mass (wLBM)" and "without low bone mass (woLBM)." Those wLBM encompasses osteoporosis, osteopenia, and below the expected range for age as recommended by the World Health Organization.
One hundred and eighty-seven patients were included. Median age was 46.3 years (interquartile range (IQR) 40-52) and duration of HAART exposure was 11.2 years (IQR 7-15). Plasma viral load was undetectable in 79%. Hypovitaminosis D (< 30 ng/mL) was present in 85% and LBM in 36.5%. Men wLBM were more likely to have testosterone deficiency and had higher PTH levels than those woLBM. LBM in women was associated with older age, menopause, and metabolic syndrome.
This study showed a high frequency of LBM in a relatively young sample, and suggests a detrimental effect of hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was frequent, especially those on non-nucleoside reverse transcriptase inhibitor, higher body mass index, and abdominal circumference.
我们对 212 名接受抗逆转录病毒治疗的艾滋病毒感染者进行了横断面研究。相对年轻的样本中，36.5%的人存在骨量减少，且与性腺功能减退、年龄较大、甲状旁腺激素水平较高和代谢综合征有关。85%的人存在维生素 D 缺乏，尤其是使用非核苷类逆转录酶抑制剂的人。
以前的研究报告称，艾滋病毒感染者（PLHIV）的骨矿物质密度（BMD）降低的发生率增加。我们旨在评估巴西 PLHIV 的 BMD、维生素 D 水平和相关危险因素。
对专门的辅助服务中的 212 名患者进行横断面研究。记录临床和人口统计学信息。进行实验室检查，并使用双能 X 射线吸收法测量腰椎、全髋/股骨颈和前臂的 BMD。参与者分为“低骨量（wLBM）”和“非低骨量（woLBM）”。那些 wLBM 包括骨质疏松症、骨质减少症和低于世界卫生组织推荐的年龄预期范围。
187 名患者被纳入研究。中位年龄为 46.3 岁（四分位间距[IQR] 40-52），抗逆转录病毒治疗暴露时间为 11.2 年（IQR 7-15）。79%的患者病毒载量不可检测。85%存在维生素 D 缺乏（<30ng/mL），36.5%存在 LBM。男性 wLBM 更可能存在睾酮缺乏，且甲状旁腺激素水平高于 woLBM。女性的 LBM 与年龄较大、绝经和代谢综合征有关。
本研究显示，在相对年轻的样本中，LBM 的发生率较高，提示性腺功能减退、年龄较大、甲状旁腺激素水平较高和代谢综合征对其有不良影响。维生素 D 缺乏很常见，尤其是使用非核苷类逆转录酶抑制剂、较高的体重指数和腰围的患者。
