Prospective study of bone mineral density changes in aging men with or at risk for HIV infection.
Prospective study of bone mineral density changes in aging men with or at risk for HIV infection.
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DOI：
10.1097/qad.0b013e32833d7da7
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发表时间：
2010-09-24
期刊：
影响因子：
--
通讯作者：
Klein RS
中科院分区：
文献类型：
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作者：
Sharma A;Flom PL;Weedon J;Klein RS
调查一组有HIV感染风险或有HIV感染风险的老年男性的骨密度(BMD)变化的比率和预测因素。年龄在≥49岁的230名艾滋病病毒感染者和159名未感染艾滋病病毒的男性的前瞻性队列研究。股骨颈、全髋关节和腰椎骨密度年变化的纵向分析。在基线时，46%的男性骨密度正常，42%的男性骨量减少，12%的男性骨质疏松。在那些骨密度正常的男性中，14%的人进展为骨量减少，86%的人继续保持正常的骨密度。在最初患有骨质疏松症的男性中，12%进展为骨质疏松症，83%继续患有骨质疏松症。未感染HIV的男性每100年的骨量减少发生率(PYAR)为2.6，感染HIV的男性为7.2；骨质疏松症的发病率在骨量减少的男性中为2.2/100 Par，与HIV状态无关。在对股骨颈骨密度年变化的多变量分析中，我们发现海洛因使用和艾滋病诊断之间存在显著的交互作用，艾滋病和海洛因使用都出现了最大的骨丢失(调整后的预测年平均骨损失为0.0196克/厘米~2)。丙型肝炎病毒血清阳性也与股骨颈骨质丢失有关(p=0.04)。艾滋病和海洛因使用之间的相互作用也与全髋骨丢失有关，目前美沙酮的使用也是如此(p<；.01)。我们发现海洛因使用和艾滋病与骨密度变化有关，这表明患有艾滋病的海洛因吸毒者可能面临特别高的骨质丢失风险。
To investigate rates and predictors of change in bone mineral density (BMD) in a cohort of aging men with or at risk for HIV infection. Prospective cohort study among 230 HIV-infected and 159 HIV-uninfected men aged ≥49 years. Longitudinal analyses of annual change in BMD at the femoral neck, total hip and lumbar spine. At baseline 46% of men had normal BMD, 42% had osteopenia, and 12% had osteoporosis. Of those men with normal BMD, 14% progressed to osteopenia and 86% continued to have normal BMD. Of the men initially with osteopenia, 12% progressed to osteoporosis, and 83% continued to have osteopenia. Osteopenia incidence per 100 person-years at risk (PYAR) was 2.6 for HIV-uninfected men and 7.2 for HIV-infected men; osteoporosis incidence was 2.2/100 PYAR among men with osteopenia, regardless of HIV status. In multivariable analysis of annual change in BMD at the femoral neck, we found a significant interaction between heroin use and AIDS diagnosis, such that the greatest bone loss occurred with both AIDS and heroin use (adjusted predicted mean annual bone loss 0.0196 gm/cm2). Hepatitis C virus seropositivity was also associated with femoral neck bone loss (p=.04). The interaction between AIDS and heroin use also was associated with bone loss at the total hip, as was current methadone use (p<.01). We found an association of heroin use and AIDS with BMD change, suggesting that heroin users with AIDS may be at particular risk for bone loss.