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Unravelling hip-spine bone mineral density discordance in people living with HIV.
Vizcarra, Pilar; Rosillo, Marta; Del Rey, José M; Moreno, Ana; Vivancos, María J; Casado, José L.
Afiliación
  • Vizcarra P; Department of Infectious Diseases, Hospital, Universitario Ramón y Cajal, Cra. Colmenar Km 9.1, 28034, Madrid, Spain. pilar1vizcarra@gmail.com.
  • Rosillo M; Department of Biochemistry, Hospital, Universitario Ramón y Cajal, Madrid, Spain.
  • Del Rey JM; Department of Biochemistry, Hospital, Universitario Ramón y Cajal, Madrid, Spain.
  • Moreno A; Department of Infectious Diseases, Hospital, Universitario Ramón y Cajal, Cra. Colmenar Km 9.1, 28034, Madrid, Spain.
  • Vivancos MJ; Department of Infectious Diseases, Hospital, Universitario Ramón y Cajal, Cra. Colmenar Km 9.1, 28034, Madrid, Spain.
  • Casado JL; Department of Infectious Diseases, Hospital, Universitario Ramón y Cajal, Cra. Colmenar Km 9.1, 28034, Madrid, Spain.
J Bone Miner Metab ; 40(6): 990-997, 2022 Nov.
Article en En | MEDLINE | ID: mdl-36038672
INTRODUCTION: In people living with HIV (PLWH), bone mineral density (BMD) discordance between the lumbar spine (LS) and femoral neck (FN) could be frequent given the high frequency of secondary osteoporosis, including HIV-related factors for bone disease. MATERIALS AND METHODS: Retrospective cohort of PLWH with a dual X-ray absorptiometry scan. Hip-spine BMD discordance was defined as different T-score or Z-scores categories at LS and FN. RESULTS: Overall, 865 individuals (mean 49.5 years, female 27%) were included. Osteoporosis diagnosis was four-to-seven times lower when both skeletal sites were affected than when considering the lowest T-score at any site (overall, 21% vs 4%). Hip-spine BMD discordance was observed in 381 (44%) individuals, it increased with age (from 43 to 52%, P = 0.032), and it was mainly due to lower LS-BMD. A lower FN-BMD was associated with older age, lower BMI (P < 0.01), and HIV-related factors, such as low CD4 + T-cell counts, duration of HIV infection, and time on antiretroviral therapy (ART). In a multivariate regression analysis, sex male (Odds Ratio, OR 4.901), hyperparathyroidism (OR, 2.364), and time on ART (OR 1.005 per month) were independently associated with discordance. A higher estimated fracture risk by FRAX equation was observed in individuals with BMD discordance due to lower FN-BMD compared to those with lower LS-BMD (+ 36% for major osteoporotic fracture, P = 0.04; + 135% for hip fracture, P < 0.01). CONCLUSION: Hip-spine BMD discordance is highly prevalent in PLWH and it is associated with classical and HIV-related risk factors, modifying the rate of osteoporosis and fracture risk estimation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Infecciones por VIH / Fracturas Osteoporóticas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Infecciones por VIH / Fracturas Osteoporóticas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Japón