Longitudinal evolution of bone mineral density and bone markers in human immunodeficiency virus-infected individuals
Longitudinal evolution of bone mineral density and bone markers in human immunodeficiency virus-infected individuals
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DOI：
10.1086/367569
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发表时间：
2003-02-15
影响因子：
11.8
通讯作者：
Tebas, P
中科院分区：
文献类型：
--
作者：
Mondy, K;Yarasheski, K;Tebas, P
人类免疫缺陷病毒（HIV）感染者中几种骨疾病的潜在机制以及与抗逆转录病毒治疗的任何关系尚未确定。进行了一项纵向研究，以估计艾滋病毒感染者中骨质减少或骨质疏松症的患病率；评估随时间变化的骨矿化、代谢和组织形态计量学；并评估诱发因素。共有 128 名患者参加了该研究，其中 93 名患者接受了 72 周的观察。低骨密度 (BMD) 和 HIV 感染持续时间的“经典”危险因素（低体重指数、减肥史、类固醇使用和吸烟）与骨质减少密切相关。低 BMD 与接受蛋白酶抑制剂治疗之间的关联性较弱；在控制了上述因素后，这种关联消失了。整个队列的骨转换标志物往往升高，但与低骨密度无关。随访期间BMD略有增加。与治疗相关因素相比，传统危险因素和晚期 HIV 感染在 HIV 感染相关骨质减少和骨质疏松症的发生中发挥着更重要的致病作用。
The underlying mechanisms of several bone disorders in human immunodeficiency virus (HIV)-infected persons and any relation to antiretroviral therapy have yet to be defined. A longitudinal study was conducted to estimate the prevalence of osteopenia or osteoporosis in HIV-infected persons; to assess bone mineralization, metabolism, and histomorphometry over time; and to evaluate predisposing factors. A total of 128 patients enrolled the study, and 93 were observed for 72 weeks. "Classic" risk factors (low body mass index, history of weight loss, steroid use, and smoking) for low bone mineral density (BMD) and duration of HIV infection were strongly associated with osteopenia. There was a weak association between low BMD and receipt of treatment with protease inhibitors; this association disappeared after controlling for the above factors. Markers of bone turnover tended to be elevated in the whole cohort but were not associated with low BMD. BMD increased slightly during follow-up. Traditional risk factors and advanced HIV infection play a more significant pathogenic role in the development of osteopenia and osteoporosis associated with HIV infection than do treatment-associated factors.