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Bone mineral and soft-tissue changes in AIDS-associated lipoatrophy.
Leonard Rosenthall1, Julian Falutz
1McGill University Health Center, 1650 Cedar Avenue, D5-195, Montreal, Canada. leonard.rosenthall@muhc.mcgill.ca
Journal of Bone and Mineral Metabolism
|December 24, 2004
Summary
Fat mass significantly impacts bone mineral content (BMC) in HIV+ males on antiretroviral therapy, independent of lean mass. Lower fat mass correlated with reduced BMC, especially in peripheral regions, highlighting fat mass
Area of Science:
- Bone Densitometry
- Body Composition Analysis
- Human Physiology
Background:
- Body weight is a known determinant of bone mass, but the relative contributions of lean mass versus fat mass remain debated.
- Highly active antiretroviral therapy (HAART) in HIV+ individuals can cause peripheral lipoatrophy, potentially uncoupling fat mass changes from lean mass.
- This presents a unique opportunity to study the independent effect of fat mass on bone mineral content (BMC).
Purpose of the Study:
- To investigate the relative influence of fat mass and lean mass on bone mineral content (BMC) in HIV+ males undergoing HAART.
- To assess if fat mass is an independent predictor of BMC, particularly in the context of HAART-induced lipoatrophy.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess total body and regional tissue composition in 102 HIV+ males.
- Participants were stratified by peripheral fat mass quartiles and regional BMC levels.
- Statistical analyses included Spearman correlation and robust multiple regression.
Main Results:
- Lower peripheral fat mass was significantly associated with lower BMC across all measured regions, despite no significant differences in lean mass.
- Fat mass emerged as an independent predictor of BMC in individuals with higher BMC levels (>50th percentile).
- Lower limb fat mass was linked to significantly lower hip bone mineral density (BMD) t-scores, suggesting localized effects.
Conclusions:
- Fat mass is a significant determinant of BMC in HIV+ males on HAART, in addition to lean mass.
- Peripheral lipoatrophy associated with HAART may preferentially affect adjacent bone mineral content.
- These findings underscore the importance of considering both lean and fat mass in bone health assessments, especially in specific patient populations.