Caeran Gabriela, de Almeida Luciana L, Ilha Thales A S H, de Carvalho José A M, Stein Carolina, Moresco Rafael N, Haygert Carlos J P, Comim Fabio V, Premaor Melissa O
Department of Clinical Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul 97105-900, Brazil.
Department of Clinical and Toxicological Analysis, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul 97105-900, Brazil.
J Endocr Soc. 2022 Sep 27;6(12):bvac148. doi: 10.1210/jendso/bvac148. eCollection 2022 Oct 26.
Despite the gain in life expectancy that people living with HIV (PLHIV) have had in the past few years, the disease is accompanied by an increase in the prevalence of noninfectious chronic diseases. PLHIV have a higher prevalence of osteoporosis, fracture, diabetes mellitus, and insulin resistance than the general population. It is unknown if insulin resistance is associated with osteoporosis and fractures in PLHIV. Our study aimed to assess the association between insulin resistance and osteoporosis in PLHIV.
A cross-sectional study was carried out in southern Brazil. PLHIV ages 50 years or older on antiretroviral treatment were included. Insulin resistance was considered present when the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was higher than expected for the Brazilian population (>2.7). The triglyceride-glucose (TyG) index was also calculated.
Of the 101 PLHIV who agreed to participate, 84 underwent insulin and bone mineral density measurements. The prevalence of osteoporosis was 19%. The frequency of insulin resistance calculated by HOMA-IR was 68.2%. Participants with osteoporosis had lower body mass index (BMI) and triglyceride values than those without it. HOMA-IR [4.8(6.6) vs 8.68(9.6), = 0.013] and TyG [5.0(0.3) vs 5.2 (0.4), = 0.029]. The association between the total femur -score disappeared after correction for BMI in the linear regression model. There was no association between vertebral fractures and insulin resistance.
In our study, PLHIV with osteoporosis have lower insulin resistance than PLHIV without it. However, this finding appears to be related to lower BMI. The association between insulin resistance and bone in PLHIV appears to be somewhat similar to that of the general population.
尽管过去几年感染人类免疫缺陷病毒（HIV）的人（PLHIV）预期寿命有所增加，但该疾病伴随着非传染性慢性病患病率的上升。PLHIV患骨质疏松症、骨折、糖尿病和胰岛素抵抗的患病率高于普通人群。尚不清楚胰岛素抵抗是否与PLHIV的骨质疏松症和骨折有关。我们的研究旨在评估PLHIV中胰岛素抵抗与骨质疏松症之间的关联。
在巴西南部进行了一项横断面研究。纳入年龄在50岁及以上接受抗逆转录病毒治疗的PLHIV。当胰岛素抵抗的稳态模型评估（HOMA-IR）高于巴西人群预期值（>2.7）时，认为存在胰岛素抵抗。还计算了甘油三酯-葡萄糖（TyG）指数。
在同意参与的101名PLHIV中，84人进行了胰岛素和骨密度测量。骨质疏松症的患病率为19%。通过HOMA-IR计算的胰岛素抵抗频率为68.2%。患有骨质疏松症的参与者的体重指数（BMI）和甘油三酯值低于未患骨质疏松症的参与者。HOMA-IR[4.8（6.6）对8.68（9.6），P = 0.013]和TyG[5.0（0.3）对5.2（0.4），P = 0.029]。在多元线性回归模型中校正BMI后，总股骨骨密度评分之间的关联消失。椎体骨折与胰岛素抵抗之间无关联。
在我们的研究中，患有骨质疏松症的PLHIV的胰岛素抵抗低于未患骨质疏松症的PLHIV。然而，这一发现似乎与较低的BMI有关。PLHIV中胰岛素抵抗与骨骼之间的关联似乎与普通人群有些相似。
