Low Bone Mineral Density, Renal Dysfunction, and Fracture Risk in HIV Infection: A Cross-Sectional Study
Low Bone Mineral Density, Renal Dysfunction, and Fracture Risk in HIV Infection: A Cross-Sectional Study
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DOI：
10.1086/644785
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发表时间：
2009-12-01
影响因子：
6.4
通讯作者：
Carr, Andrew
中科院分区：
文献类型：
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作者：
Calmy, Alexandra;Fux, Christoph A.;Carr, Andrew
背景骨矿物质密度（BMD）降低在感染人类免疫缺陷病毒（HIV）的成年人中很常见。近端肾小管功能障碍（PRTD）和骨代谢改变在HIV相关性低BMD中的作用尚未完全了解。我们在门诊护理环境中定量BMD（双能X线吸收法）、骨代谢和肾功能的血液和尿液标志物以及低BMD的风险因素（髋关节或脊柱T评分，-1或更低）。我们确定了与低BMD相关的因素，并使用世界卫生组织FRAX方程计算了10年骨折风险。我们研究了153名成年人（98%为男性;中位年龄48岁;中位体重指数24.5; 67名[44%]接受替诺福韦，81名[53%]接受蛋白酶抑制剂[PI]）。65名参与者（42%）有低BMD，11名（7%）有PRTD。在多变量分析中，PI治疗与低BMD相关（比值比，2.69; 95%置信区间，1.09-6.63）。替诺福韦的使用与成骨细胞和破骨细胞活性的增加有关（P
Background. Reduced bone mineral density (BMD) is common in adults infected with human immunodeficiency virus (HIV). The role of proximal renal tubular dysfunction (PRTD) and alterations in bone metabolism in HIV-related low BMD are incompletely understood.Methods. We quantified BMD (dual-energy x-ray absorptiometry), blood and urinary markers of bone metabolism and renal function, and risk factors for low BMD ( hip or spine T score, -1 or less) in an ambulatory care setting. We determined factors associated with low BMD and calculated 10-year fracture risks using the World Health Organization FRAX equation.Results. We studied 153 adults (98% men; median age, 48 years; median body mass index, 24.5; 67 [44%] were receiving tenofovir, 81 [53%] were receiving a boosted protease inhibitor [PI]). Sixty-five participants (42%) had low BMD, and 11 (7%) had PRTD. PI therapy was associated with low BMD in multivariable analysis ( odds ratio, 2.69; 95% confidence interval, 1.09-6.63). Tenofovir use was associated with increased osteoblast and osteoclast activity (P