Associations between Bone Density and Body Composition in Persons Living with HIV.
prevalence of osteoporosis is higher in persons living with HIV (PLWH) than in
HIV-uninfected individuals. PLWH also have an increased risk of developing an adipose
redistribution syndrome (HARS) and muscle loss. Data examining the relationships between
bone, fat and muscle mass in PLWH are scarce and inconsistent. We examined the
association between total body bone mineral dens... read moreity (BMD) with measures of central and
appendicular fat and lean body mass in men and women living with HIV. HIV-positive men
(n=466; mean age 46 years) and women (n=153; mean age 43 years) were evaluated for total
body BMD by dual energy x-ray absorptiometry (DXA), anthropometric indices of central
(waist circumference) and appendicular fat (triceps skin-fold), and DXA-derived measures
(trunk-to-extremity fat ratio, trunk fat, appendicular fat, and percent lean body mass).
From this cohort, 297 men and 101 women were included in the longitudinal analysis.
Multivariable linear regression, separately in each sex, assessed the relationship
between total body BMD and each of the body composition measures in the cross-sectional
analyses; and between baseline trunk-to-extremity fat ratio and 2-year change in total
body BMD. We found that trunk-to-extremity fat ratio was associated with lower total
body BMD in men (β=-0.02, p=0.01). Both higher central and appendicular fat
measurements were associated with lower total body BMD in men (p for all <0.05 except
appendicular fat by DXA, p=0.1), but not women (β=0.02, p=0.2), after
multivariable adjustment. Percent lean body mass was positively associated with total
body BMD in men (β=0.004, p<0.001), and women (β=0.003, p=0.06). Baseline
trunk-to-extremity fat ratio and percent lean mass were not significantly associated
with 2-year changes in total body BMD in men or women. In this cohort, there was a
positive association between lean mass and total body BMD in both sexes with HIV,
implying that lean mass is an important determinant of BMD in this population. Our study
also found a negative association between measures of body fat and total body BMD in men
with HIV, suggesting that higher fat mass in men with HIV may have an adverse effect on
BMD. Baseline body composition measures did not predict change in total body BMD over a
2-year period. Larger and longer-term studies are needed to confirm these
Thesis (M.S.)--Tufts University, 2014.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Christine Wanke.
Committee: Lisa Ceglia, Jessica Paulus, and Farzad Noubary.
Keyword: Endocrinology.read less