Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Medicine, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA.
J Gerontol A Biol Sci Med Sci. 2024 Nov 1;79(11). doi: 10.1093/gerona/glae229.
People with HIV (PWH) experience faster physical decline than those without HIV (PWoH), despite antiretroviral therapy. We compared skeletal muscle density and area and their relationship with physical function among PWH and PWoH.
Quantitative computed tomography scans were performed at the L4-L5 spinal region and the thigh to evaluate muscle groups in Multicenter AIDS Cohort Study participants at baseline. Using exploratory factor analysis, we summarized aggregated muscle measures based on factor loadings. Longitudinal associations between muscle area and density with gait speed and grip strength were examined using multivariable linear regression models with generalized estimating equations, adjusting for demographics, HIV serostatus, and other health metrics.
We included 798 men (61% of PWH). The median age was 54 years (interquartile range: 49-59), 61% were White, 32% Black, and 10% Hispanic. Among them, 22% had a body mass index over 30 kg/m2, and 14% had diabetes. Two factors emerged from the factor analysis explaining 55.9% of variance. Factor 1 (explained 32.5% of variance) encompassed all density measures. Factor 2 (explained 23.4% of variance) encompassed all area measures. Associations between muscle density and gait speed were more pronounced with aggregated measures than with individual ones. Specifically, each unit increase in overall muscle density correlated with a 0.028 m/s increase in gait speed (95% confidence interval [CI]: 0.017, 0.038, p < .01). Grip strength was associated with aggregated measures of both muscle density and area, with overall muscle density associated with a 1.88 kg increase in grip strength (95% CI: 1.29, 2.46, p < .01), and overall muscle area with a 1.60 kg increase (95% CI: 1.02, 2.19, p < .01).
Aggregated muscle density and area measurements were significantly associated with physical function. These correlations underscore the importance of interventions to enhance skeletal muscle to improve healthy aging for PWH and PWoH.
尽管有抗逆转录病毒疗法，HIV 感染者（PWH）的身体衰退速度仍快于未感染 HIV 的人（PWoH）。我们比较了 PWH 和 PWoH 的骨骼肌密度和面积及其与身体功能的关系。
在 Multicenter AIDS Cohort Study 参与者的基线时，使用定量计算机断层扫描（qCT）在 L4-L5 脊柱区和大腿处评估肌肉群。使用探索性因子分析，根据因子负荷对聚合的肌肉测量值进行总结。使用广义估计方程的多变量线性回归模型，调整人口统计学、HIV 血清状态和其他健康指标，检查肌肉面积和密度与步态速度和握力之间的纵向关联。
我们纳入了 798 名男性（PWH 占 61%）。中位年龄为 54 岁（四分位距：49-59），61%为白人，32%为黑人，10%为西班牙裔。其中，22%的人体重指数超过 30kg/m2，14%患有糖尿病。因子分析得出了两个因子，解释了 55.9%的方差。因子 1（解释了 32.5%的方差）包含所有密度测量值。因子 2（解释了 23.4%的方差）包含所有面积测量值。与个体测量值相比，聚合测量值与肌肉密度和步态速度之间的关联更显著。具体而言，肌肉密度每增加一个单位，步态速度就会增加 0.028m/s（95%置信区间：0.017，0.038，p<.01）。握力与肌肉密度和面积的聚合测量值均相关，总肌肉密度与握力增加 1.88kg（95%置信区间：1.29，2.46，p<.01）相关，总肌肉面积与握力增加 1.60kg（95%置信区间：1.02，2.19，p<.01）相关。
聚合的肌肉密度和面积测量值与身体功能显著相关。这些相关性强调了干预措施增强骨骼肌的重要性，以改善 HIV 感染者和未感染者的健康老龄化。
