Prevalence and associated factors of low bone mineral density in people living with HIV: a cross-sectional study

Shao, Yueming1; Sun, Jinfeng1; Kong, Keyu2; Zhang, Rengyin3; Zhang, Renfang1; Liu, Li1; Wang, Jiangrong1; Shen, Yinzhong1; Wu, Luling1,4; Zheng, Zhihang1,5; Sun, Meiyan1; Qi, Tangkai1; Wang, Zhenyan1; Tang, Yang1; Sun, Jianjun1; Song, Wei1; Yang, Junyang1; Xu, Shuibao1; Zhao, Bihe1; Shan, Fei3; Qin, An2; Lu, Hongzhou6; Chen, Jun1

2024-07-02

10.1007/s11657-024-01413-3

ARCHIVES OF OSTEOPOROSIS   影响因子和分区

1862-3522

1862-3514

This study examined low bone mineral density (BMD) prevalence and associated factors among Chinese people living with HIV (PLWH), uncovering a persistent high BMD risk in older individuals, even after adjusting for age and body mass index (BMI). Notably, lopinavir/ritonavir (LPV/r) therapy was linked to reduced BMD, highlighting the imperative need for regular BMD monitoring and interventions in older PLWH. Purpose HIV infection and antiretroviral therapy (ART) have been shown to contribute to lower BMD, resulting in an increased susceptibility to osteopenia and osteoporosis. However, there is limited knowledge about the prevalence of reduced BMD and its associated factors among Chinese PLWH. In this cross-sectional study, we aimed to investigate the prevalence and factors associated with low BMD among PLWH in China. Methods We retrospectively enrolled PLWH and non-HIV volunteers who underwent dual-energy X-ray absorptiometry (DXA) scans to measure bone density. Demographic information, laboratory test results, ART regimens, and treatment duration were collected. Univariate and multiple regression analyses were performed to identify factors influencing abnormal bone mass in PLWH. Results A total of 829 individuals were included in this study, comprising the HIV group (n = 706) and the non-HIV group (n = 123). The prevalence of low BMD among all PLWH was found to be 13.88% (98 out of 706). However, among PLWH aged 50 years and above, the prevalence increased to 65.32% (81 out of 124). In contrast, control subjects in the same age group had a prevalence of 38.21% (47 out of 123). After adjusting for age and BMI, older PLWH still demonstrated a higher prevalence of low BMD compared to the non-HIV group (68.24% vs 34.94%, P < 0.001). Multivariate analysis revealed that older age was strongly associated with a higher risk of low BMD among PLWH, with an odds ratio (OR) of 6.28 for every 10-year increase in age in the ART-na & iuml;ve population (95% confidence intervals [CIs], 3.12-12.65; P < 0.001) and OR of 4.83 in the ART-experienced population (3.20-7.29, P < 0.001). Within the ART-experienced group, current LPV/r treatment was associated with an increased risk of low BMD (OR = 3.55, 1.24-10.14, P < 0.05), along with lower BMI (OR = 0.84, 0.75-0.95, P < 0.05), and elevated alkaline phosphatase (OR = 1.02, 1.01-1.03, P < 0.01). Conclusion The prevalence of low BMD is higher among PLWH aged 50 years and above compared to non-HIV individuals. The use of LPV/r for ART is associated with reduced BMD. These findings emphasize the importance of regular monitoring of BMD in older PLWH and the need for appropriate interventions to mitigate the risks of osteopenia and osteoporosis in this population.

Bone mineral density HIV Antiretroviral therapy Osteopenia Osteoporosis

SCI

英语

通讯

Shanghai Commission of Science and Technology["21Y11901200","20MC1920100","21Y31900400"] ; Shanghai Shenkang Hospital Developing Center[SHDC2020CR6025]

Endocrinology & Metabolism ; Orthopedics

Endocrinology & Metabolism ; Orthopedics

WOS:001261457700001

SPRINGER LONDON LTD

Web of Science

1.Fudan Univ, Shanghai Publ Hlth Clin Ctr, Dept Infect & Immun, Shanghai 201508, Peoples R China
2.Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Dept Orthopaed Surg, Shanghai Key Lab Orthopaed Implants,Sch Med, Shanghai, Peoples R China
3.Fudan Univ, Shanghai Publ Hlth Clin Ctr, Dept Radiol, Shanghai, Peoples R China
4.Fudan Univ, Huashan Hosp, Inst Antibiot, Shanghai, Peoples R China
5.Fudan Univ, Shanghai Inst Infect Dis & Biosecur, Shanghai, Peoples R China
6.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Affiliated Hosp 2, Natl Clin Res Ctr Infect Dis,Dept Infect Dis,Sch M, Shenzhen 518112, Guangdong, Peoples R China

Shao, Yueming,Sun, Jinfeng,Kong, Keyu,et al. Prevalence and associated factors of low bone mineral density in people living with HIV: a cross-sectional study[J]. ARCHIVES OF OSTEOPOROSIS,2024,19(1).

Shao, Yueming.,Sun, Jinfeng.,Kong, Keyu.,Zhang, Rengyin.,Zhang, Renfang.,...&Chen, Jun.(2024).Prevalence and associated factors of low bone mineral density in people living with HIV: a cross-sectional study.ARCHIVES OF OSTEOPOROSIS,19(1).

Shao, Yueming,et al."Prevalence and associated factors of low bone mineral density in people living with HIV: a cross-sectional study".ARCHIVES OF OSTEOPOROSIS 19.1(2024).