HIV infection and bone mineral density in middle-aged women
HIV infection and bone mineral density in middle-aged women
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DOI：
10.1086/501015
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发表时间：
2006-04-01
影响因子：
11.8
通讯作者：
Schoenbaum, EE
中科院分区：
文献类型：
--
作者：
Arnsten, JH;Freeman, R;Schoenbaum, EE
背景骨质减少在人类免疫缺陷病毒（HIV）感染者中普遍存在，是女性正常衰老过程的一部分。大多数关于骨矿物质密度（BMD）和HIV感染的研究都集中在男性身上，或者缺乏具有相似行为危险因素的无HIV感染个体的对照组。我们分析了495名中年妇女（定义为年龄≥ 40岁的妇女）的BMD; 263名妇女有HIV感染，232名妇女为HIV阴性，其行为危险因素与HIV阳性组相似。研究中女性的平均年龄为44岁，54%是黑人，92%使用过非法药物。与未感染HIV的女性相比，感染HIV的女性股骨颈BMD和腰椎BMD降低（股骨颈BMD，g/cm（2）vs. g/cm（2）;腰椎1.01 +/- 0.13 1.05 +/- 0.13 Pp. 001脊柱BMD，g/cm（2）vs. g/cm（2）;）。除了HIV感染，其他因素独立1.21 +/- 0.17 1.24 +/- 0.17 P = 0.04与两个部位的BMD较低相关，年龄较大，不是黑人，体重较轻。在种族分层多变量分析中，HIV感染仅与非黑人女性的BMD相关。在HIV阳性的妇女中，84%服用过抗逆转录病毒药物，62%服用过蛋白酶抑制剂，但它们的使用与BMD无关。美沙酮治疗也与腰椎BMD降低独立相关。与HIV感染风险相似的女性相比，HIV感染的中年女性BMD降低，与抗逆转录病毒药物使用无关。在艾滋病毒呈阳性的妇女中，那些不是黑人、体重不足和使用阿片类药物的妇女可能面临特别的风险。虽然在这一队列中，感染艾滋病毒的妇女BMD降低的患病率高于未感染艾滋病毒的妇女（27%对19%），但与国家估计值和先前涉及艾滋病毒阳性妇女和男子的研究相比，BMD降低的总体患病率较低。
Background. Osteopenia is prevalent in persons with human immunodeficiency virus ( HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density ( BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors.Methods. We analyzed BMD in 495 middle-aged women ( defined as women >= 40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group.Results. The median age of the women in the study was 44 years, 54% were black, and 92% had used illicit drugs. Femoral neck BMD and lumbar spine BMD were reduced in women with HIV infection, compared with women without HIV infection ( femoral neck BMD, g/cm(2) vs. g/cm(2);; lumbar 1.01 +/- 0.13 1.05 +/- 0.13 Pp. 001 spine BMD, g/cm(2) vs. g/cm(2);). In addition to HIV infection, other factors independently 1.21 +/- 0.17 1.24 +/- 0.17 P = .04 dependently associated with lower BMD in both sites were being older, not being black, and having a low body weight. In race-stratified multivariate analyses, HIV infection was associated with BMD only in non-black women. Among HIV-positive women, 84% had taken antiretrovirals, and 62% had taken protease inhibitors, but their use was not associated with BMD. Methadone treatment was also independently associated with reduced lumbar spine BMD.Conclusion. Middle-aged women with HIV infection have reduced BMD, compared with women at similar risk for HIV infection, independent of antiretroviral use. Among HIV-positive women, those who are not black, who are underweight, and who use opiates may be at particular risk. Although the prevalence of reduced BMD in this cohort was higher among women with HIV infection than among those without ( 27% vs. 19%), the overall prevalence of reduced BMD was low, compared with national estimates and with previous studies involving HIVpositive women and men.