Prevalence and risk factors for bone mineral density changes in antiretroviral therapy-naive human immunodeficiency virus-infected adults:a Chinese cohort study  

作　　者：Yong-Qin Zeng Jiang Xiao Cui-Lin Li Yu Wang Ling Zhang Xiao-Li Pang Di Wang Juan Du Hong-Xin Zhao 

机构地区：[1]Department of Infection,Beijing Ditan Hospital,Peking University,Beijing 100015,China [2]Clinical and Research Center of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China

出　　处：《Chinese Medical Journal》2020年第24期2940-2946,共7页中华医学杂志（英文版）

基　　金：National Key Project"Prevention and Therapy of Fatal Infectious Diseases such AIDS&Viral Hepatitis:Popularization and application of diagnosis and treatment of Belt and Road HIV/AIDS with Traditional Chinese Medicine"(No.2018ZX10101001-005-001);the National Key Project"The Development of New Pharmaceuticals:the Construction of Platform for Clinical Evaluation of New Antiretroviral Therapy-Clinical trial phase I-IV"(No.2017ZX09304027-001-010);the Thirteen-fifth Key Project"The Study of Construction of Representative Areas for Prevention and Therapy of Fatal Infectious Diseases such AIDS&Viral Hepatitis in Chaoyang District,Beijing"(No.2018ZX10715-005);the National Natural Science Foundation"The Study for Delay and Persistent Poor Immune Reconstitution in HIV/AIDS Patients"(No.81672000);Project from Beijing Municipal Committee of Science&Technology"The study of HIV/HBV co-infection"(No.D161100000416004);Project for Capital Characteristics"The study for blood concentration of efavirenz influenced by rifampin in HIV/TB co-infected patient"(No.Z171100001017053);The Key Project from Beijing Hospital Authority(No.DFL20191802);Major Project of Beijing Municipal Science and Technology Committee(No.D161100000416003)。

摘　　要：Background Studies have reported that low bone mineral density(BMD)is prevalent in human immunodeficiency virus(HIV)-infected patients;however,the factors that contribute to HIV-related BMD changes are yet to be fully understood.Due to the application of dual X-ray absorptiometry(DXA)among a select group of hospitals only,the prevalence and risk factors of low BMD in HIV-infected populations have not been intensively investigated in China.Thus,the aim of our study was to investigate the prevalence of and risk factors associated with BMD changes among antiretroviral therapy(ART)-naive HIV-positive patients in China.Methods The assessment of the prevalence of and risk factors associated with BMD changes was conducted among 156 ART-naive HIV-infected patients.Demographic and clinical data,as well as results of fasting blood tests were obtained from patients.Further,all patients underwent DXA scans to determine BMD,which was then used to classify patients with osteopenia/osteoporosis.The risk factors of reduced BMD were then evaluated using binary logistic regression.Results Among the 156 ART-naive HIV-infected participants,osteopenia and osteoporosis were diagnosed in 48.7%(76/156)and 4.5%(7/156)of patients,respectively.The lumbar spine was most likely to have reduced BMD(49.4%[77/156]),and the proportion of osteopenia in the left hip(32.7%[51/156])was higher than in the right hip(24.4%[38/156]).In the lumbar spine,bone loss rate in the L1 section(60.9%[95/156])was the most significant(L2,53.2%[83/156];L3,45.5%[71/156];L4,52.6%[82/156]).Further analysis showed that,compared with the neck(26.9%[42/156]in the left,18.6%[29/156]in the right)and the interior(15.4%[24/156]in the left,13.5%[21/156]in the right),the trochanter had the greatest probability of reduced BMD(46.2%[72/156]in the left,28.8%[45/156]in the right).In the risk factor analysis,low body mass index(BMI:<18.5 kg/m2)was positively associated with reduced BMD(Exp(B)=39.743,95%confidence interval:3.234-488.399,P=0.004),and was specifically positively correl

关 键 词：Human immunodeficiency virus(HIV) Antiretroviral therapy-naive Bone mineral density Body mass index 

分 类 号：R512.91[医药卫生—内科学]