Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.
Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.
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DOI：
10.1111/hiv.12242
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发表时间：
2015-04
期刊：
影响因子：
3
通讯作者：
International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
中科院分区：
文献类型：
--
作者：
Carr A;Grund B;Neuhaus J;Schwartz A;Bernardino JI;White D;Badel-Faesen S;Avihingsanon A;Ensrud K;Hoy J;International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
与普通人群相比，HIV感染与低骨密度（BMD）和骨折的患病率较高相关。在未经抗逆转录病毒治疗（ART）的HIV阳性成人中，估计未经治疗的HIV对骨丢失的相对贡献的数据有限。START骨矿物质密度子研究是一项随机比较立即与延迟初始ART对骨的影响的研究。我们评估了传统的、人口统计学的、HIV相关的和免疫学的因素与基线髋部和腰椎BMD的关系，这些BMD通过双能X线吸收测量法测量，使用多元回归。在六大洲的33个研究中心共招募了424名ART初治受试者;平均（SD）年龄为34（10.1）岁，79.0%为非白人，26.0%为女性，12.5%的体重指数（BMI）<20 kg/m2。脊柱的平均（SD）Z评分为-0.41（0.94），全髋为-0.36（0.88）; 1.9%患有骨质疏松症，35.1%患有低BMD（髋关节或脊柱T评分<-1.0）。与髋部和脊柱BMD较低独立相关的因素是女性、拉丁裔/西班牙裔、较低的BMI和较高的估计肾小球滤过率。较长的时间，因为艾滋病毒的诊断与较低的髋部骨密度。当前或最低CD 4细胞计数和HIV病毒载量与BMD无关。在这一地理和种族多样的CD 4细胞计数正常的ART初治成人人群中，低BMD很常见，但骨质疏松症很罕见。较低的BMD与传统的危险因素显著相关，但与CD 4细胞计数或病毒载量无关。
HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than the general population. There are limited data in HIV-positive adults, naïve to antiretroviral therapy (ART), to estimate the relative contribution of untreated HIV to bone loss. The START Bone Mineral Density substudy is a randomised comparison of the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV-related, and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual-energy x-ray absorptiometry, using multiple regression. A total of 424 ART-naïve participants were enrolled at 33 sites in six continents; mean (SD) age was 34 (10.1) years, 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) <20 kg/m2. Mean (SD) Z-scores were -0.41 (0.94) at the spine and -0.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD (hip or spine T-score <-1.0). Factors independently associated with lower BMD at the hip and spine were female sex, Latino/Hispanic ethnicity, lower BMI and higher estimated glomerular filtration rate. Longer time since HIV diagnosis was associated with lower hip BMD. Current or nadir CD4 cell counts, and HIV viral load were not associated with BMD. In this geographically and racially diverse population of ART-naïve adults with normal CD4 cell counts, low BMD was common, but osteoporosis was rare. Lower BMD was significantly associated with traditional risk factors but not with CD4 cell count or viral load.
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影响因子：
4
作者：
Hamill, M. M.;Ward, K. A.;Pettifor, J. M.;Norris, S. A.;Prentice, A.
通讯作者：
Prentice, A.
影响因子：
6.2
作者：
Hui, SL;Gao, SJ;Genant, H
通讯作者：
Genant, H
影响因子：
11.8
作者：
Grant, Philip M.;Kitch, Douglas;Brown, Todd T.
通讯作者：
Brown, Todd T.
DOI：
10.1097/med.0b013e328340533d
发表时间：
2010-12-01
影响因子：
3.2
作者：
Kamen, Diane L.;Alele, Jimmy D.
通讯作者：
Alele, Jimmy D.
DOI：
10.1177/1740774512440342
发表时间：
2013
期刊：
Clinical trials (London, England)
影响因子：
--
作者：
Babiker AG;Emery S;Fätkenheuer G;Gordin FM;Grund B;Lundgren JD;Neaton JD;Pett SL;Phillips A;Touloumi G;Vjechaj MJ;INSIGHT START Study Group
通讯作者：
INSIGHT START Study Group