Viral hepatitis is associated with reduced bone mineral density in HIV-infected women but not men.
Viral hepatitis is associated with reduced bone mineral density in HIV-infected women but not men.
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DOI：
10.1097/qad.0b013e32832ec258
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发表时间：
2009-10-23
期刊：
影响因子：
--
通讯作者：
Tebas P
中科院分区：
文献类型：
--
作者：
Lo Re V 3rd;Guaraldi G;Leonard MB;Localio AR;Lin J;Orlando G;Zirilli L;Rochira V;Kostman JR;Tebas P
Few studies have examined the impact of viral hepatitis on bone mineral density (BMD), and none have done so among HIV-infected patients. Our objective was to determine if viral hepatitis was associated with low BMD in HIV. Cross-sectional study among 1,237 HIV-infected subjects (625 with viral hepatitis). Dual-energy x-ray absorptiometry (DXA) scans of the lumbar spine and femoral neck were obtained. Clinical data, hepatitis B and C status, and markers of bone metabolism were determined at DXA scanning. Multivariable logistic regression examined the association between hepatitis and low BMD (Z-score ≤−2.0 at the lumbar spine and/or femoral neck). Mean BMD Z-scores were lower among hepatitis-coinfected women at the lumbar spine (−0.15 versus +0.29; difference=−0.44 [95% CI, −0.65 to −0.23]; p<0.001) and femoral neck (−0.64 versus −0.39; difference=−0.25 [95% CI, −0.44 to −0.06]; p=0.009) compared to HIV-monoinfected women. No differences in mean BMD Z-scores were observed between coinfected and monoinfected men. After adjustment for age, body mass index, duration of HIV, antiretroviral use, physical activity, and smoking, viral hepatitis was associated with low BMD among women (adjusted OR, 2.87; 95% CI, 1.31 – 6.29) but not men (adjusted OR, 1.19; 95% CI, 0.74 – 1.91). Coinfected women had lower mean parathyroid hormone (60.1 versus 68.1 pg/mL; p=0.02) but similar mean 25-hydroxyvitamin D (19.1 versus 19.6 ng/mL; p=0.6) and osteocalcin (3.0 versus 3.2 ng/mL; p=0.8) concentrations than HIV-monoinfected women. Viral hepatitis was associated with a higher risk of low BMD among HIV-infected women but not men.
