处于不同生殖阶段的感染和未感染艾滋病毒女性的骨矿物质密度纵向评估

Longitudinal Assessment of Bone Mineral Density in Women Living With and Without HIV Across Reproductive Phases.

作者信息

Swann Shayda A, King Elizabeth M, Prior Jerilynn C, Berger Claudie, Mayer Ulrike, Pick Neora, Campbell Amber R, Côté Hélène C F, Murray Melanie C M

机构信息

Experimental Medicine, University of British Columbia, Vancouver, Canada.

Women's Health Research Institute, Vancouver, Canada.

出版信息

J Acquir Immune Defic Syndr. 2024 Feb 1;95(2):197-206. doi: 10.1097/QAI.0000000000003336.

DOI:10.1097/QAI.0000000000003336

PMID:37963371

Abstract

BACKGROUND

Women living with HIV commonly experience low areal bone mineral density (BMD), but whether this is affected by low ovarian hormonal states (prolonged amenorrhea or menopause) is unknown. We compared rates of BMD loss between women living with HIV and HIV-negative control women and investigated its association with low ovarian hormonal states.

SETTING

Women living with HIV were enrolled from Vancouver Canada and controls from 9 Canadian sites.

METHODS

This longitudinal analysis included age-matched women living with HIV in the Children and Women: AntiRetrovirals and Markers of Aging cohort and controls in the population-based Canadian Multicentre Osteoporosis Study. Rate of change/year in BMD at the total hip and lumbar spine (L1-L4) between 3 and 5 years was compared between groups, adjusting for sociodemographic and clinical variables.

RESULTS

Ninety-two women living with HIV (median [interquartile range] age: 49.5 [41.6-54.1] years and body mass index: 24.1 [20.7-30.8] kg/m 2 ) and 278 controls (age: 49.0 [43.0-55.0] years and body mass index: 25.8 [22.9-30.6] kg/m 2 ) were included. Total hip BMD loss was associated with HIV (β: -0.003 [95% CI: -0.006 to -0.0001] g/cm 2 /yr), menopause (β: -0.007 [-0.01 to -0.005] g/cm 2 /yr), and smoking (β: -0.003 [-0.006 to -0.0002] g/cm 2 /yr); BMD gain was linked with higher body mass index (β: 0.0002 [0.0007-0.0004] g/cm 2 /yr). Menopause was associated with losing L1-L4 BMD (β: -0.01 [-0.01 to -0.006] g/cm 2 /yr). Amenorrhea was not associated with BMD loss.

CONCLUSIONS

HIV and menopause negatively influenced total hip BMD. These data suggest women living with HIV require hip BMD monitoring as they age.

摘要

背景

感染艾滋病毒的女性通常存在低骨面积骨密度（BMD），但这是否受低卵巢激素状态（长期闭经或绝经）影响尚不清楚。我们比较了感染艾滋病毒的女性与未感染艾滋病毒的对照女性的骨密度损失率，并研究了其与低卵巢激素状态的关联。

研究背景

感染艾滋病毒的女性来自加拿大温哥华，对照组来自加拿大9个地点。

方法

这项纵向分析纳入了儿童与妇女：抗逆转录病毒药物与衰老标志物队列中年龄匹配的感染艾滋病毒的女性，以及基于人群的加拿大多中心骨质疏松研究中的对照组。比较了两组在3至5年间全髋关节和腰椎（L1-L4）骨密度的年变化率，并对社会人口统计学和临床变量进行了调整。

结果

纳入了92名感染艾滋病毒的女性（年龄中位数[四分位间距]：49.5[41.6-54.1]岁，体重指数：24.1[20.7-30.8]kg/m²）和278名对照组女性（年龄：49.0[43.0-55.0]岁，体重指数：25.8[22.9-30.6]kg/m²）。全髋关节骨密度损失与艾滋病毒感染（β：-0.003[95%置信区间：-0.006至-0.0001]g/cm²/年）、绝经（β：-0.007[-0.01至-0.005]g/cm²/年）和吸烟（β：-0.003[-0.006至-0.0002]g/cm²/年）有关；骨密度增加与较高的体重指数有关（β：0.0002[0.0007-0.0004]g/cm²/年）。绝经与L1-L4骨密度降低有关（β：-0.01[-0.01至-0.006]g/cm²/年）。闭经与骨密度损失无关。