Sarcopenia, its components and fracture risk in people living with human immunodeficiency virus

The aim of this study was to evaluate the relationship between sarcopenia and its components with fracture risk in people living with human immunodeficiency virus, and to assess the association with sociodemographic and clinical characteristics.

This cross-sectional study was conducted with people living with human immunodeficiency virus undergoing antiretroviral therapy in the state of Mato Grosso do Sul, Brazil. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria, assessing muscle strength (handgrip strength), skeletal muscle mass (skeletal muscle mass index), and physical performance (gait speed). The 10-year risk of major osteoporotic and hip fracture was estimated using the Brazilian version of the Fracture Risk Assessment Tool (FRAX®). Statistical analyses included chi-square tests, analysis of variance, and Spearman correlation (p<0.05).

Among 105 participants (44.6±13.5 years), the prevalence of confirmed or severe sarcopenia was 6.7%. No association was found between sarcopenia and the risk of major fracture (p=0.471) or hip fracture (p=0.254). However, handgrip strength was correlated with the risk of major fracture (ρ=-0.21; p=0.029) and hip fracture (ρ=-0.25; p=0.010). SMII showed moderate correlations with major fracture risk (ρ=-0.44; p<0.01) and hip fracture risk (ρ=-0.52; p<0.01). Gait speed was correlated only with hip fracture risk (ρ=-0.22; p=0.025). Older age (p<0.001) and lower body mass index (p=0.011) were significant risk factors.

Sarcopenia as a categorical diagnosis was not associated with fracture risk, whereas lower handgrip strength and skeletal muscle mass index were associated with higher FRAX® estimates, and gait speed only with hip fracture risk. These findings support assessing sarcopenia-related parameters in people living with human immunodeficiency virus.