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Hip bone geometry in HIV/HCV-co-infected men and healthy controls
V Walker Harris1, C G Sutcliffe, A B Araujo
1Johns Hopkins University School of Medicine, Baltimore, MD, USA. vwalker4@jhmi.edu
Insights
Men with HIV and hepatitis C have weaker hip bones than healthy men, primarily due to lower lean body mass. This finding highlights a significant bone health risk in HIV/HCV co-infection.
Area of Science:
- Bone health and osteoporosis research
- Infectious disease and co-morbidity studies
- Human physiology and body composition analysis
Background:
- Hepatitis C co-infection is a known risk factor for fragility fractures in individuals with HIV.
- The impact of HIV/HCV co-infection on bone strength remains largely uncharacterized.
Purpose of the Study:
- To compare hip strength between men with HIV/HCV co-infection and healthy controls.
- To investigate the role of body composition, specifically lean body mass, in reduced bone strength.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess hip geometry and bone strength in 88 HIV/HCV-co-infected men and 289 healthy men.
- Hip structural analysis measured parameters at the narrow neck, intertrochanter, and shaft.
- Linear regression models were employed to analyze the relationship between body composition (lean body mass, fat mass) and bone strength.
Main Results:
- HIV/HCV-co-infected men exhibited lower BMI, lean body mass (LBM), and fat mass (FM) compared to controls.
- Significant differences in narrow neck bone mineral density, cross-sectional area, section modulus, buckling ratio, and centroid position were observed.
- Reduced LBM, not FM or FMR, accounted for the majority of the differences in narrow neck bone strength parameters between the cohorts.
Conclusions:
- HIV/HCV-co-infected men demonstrate compromised hip strength at the narrow neck.
- Lower lean body mass is the primary contributor to this decreased hip strength in HIV/HCV-co-infected individuals.
Unlabelled:
People with both HIV and hepatitis C are more likely than those with HIV alone to have wrist, hip, and spine fractures. We compared hip strength between HIV/HCV-co-infected men and healthy men and found that HIV/HCV-co-infected men had decreased hip strength due to lower lean body mass.
Introduction:
Hepatitis C co-infection is a risk factor for fragility fracture among HIV-infected populations. Whether bone strength is compromised in HIV/HCV-co-infected patients is unknown.
Methods:
We compared dual-energy x-ray absorptiometry (DXA)-derived hip geometry, a measure of bone strength, in 88 HIV/HCV-co-infected men from the Johns Hopkins HIV Clinic to 289 men of similar age and race and without HIV or HCV from the Boston Area Community Health Survey/Bone Survey. Hip geometry was assessed at the narrow neck, intertrochanter, and shaft using hip structural analysis. Lean body mass (LBM), total fat mass (FM), and fat mass ratio (FMR) were measured by whole-body DXA. Linear regression was used to identify body composition parameters that accounted for differences in bone strength between cohorts.
Results:
HIV/HCV-co-infected men had lower BMI, LBM, and FM and higher FMR compared to controls (all p < 0.05). At the narrow neck, significant differences were observed between HIV/HCV-co-infected men and controls in bone mineral density, cross-sectional area, section modulus, buckling ratio, and centroid position. After adjustment for race, age, smoking status, height, and weight, only buckling ratio and centroid position remained significantly different between cohorts (all p < 0.05). Substituting LBM, FM, and FMR for weight in the multivariate model revealed that differences in LBM, but not FM or FMR, accounted for differences in all narrow neck parameters between cohorts, except buckling ratio and centroid position.
Conclusion:
HIV/HCV-co-infected men have compromised hip strength at the narrow neck compared to uninfected controls, which is attributable in large part to lower lean body mass.
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