中年男性艾滋病毒感染者的皮层和椎骨缺陷
Namki Hong1,2, Jung Ho Kim3, Graham Treece4
1Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
概括
与对照组相比,患有人类免疫缺陷病毒 (MLWH) 的中年男性的关节骨密度和骨缺陷明显较低. 较低的CD4计数和蛋白酶抑制剂治疗方案与MLWH的骨密度降低有关.
科学领域:
- 骨代谢和艾滋病病毒研究
- 医学成像和诊断 医学成像和诊断
背景情况:
- 携带艾滋病毒的中年男性 (MLWH) 面临部骨折的高风险,比未感染者早近十年发生.
- 有限的数据存在于MLWH的特定关节骨缺陷 (皮质和椎),对于了解骨强度至关重要.
- 人类免疫缺陷病毒 (HIV) 感染及其治疗方法可能会影响骨健康.
研究的目的:
- 为了比较MLWH和健康对照之间的关节骨密度和结构参数.
- 研究MLWH中抗逆转录病毒疗法 (ART) 方案,CD4计数和骨健康之间的关联.
- 在MLWH中确定皮质和椎骨缺陷的特定区域.
主要方法:
- 对83个MLWH和166个年龄和BMI匹配的对照进行了定量CT扫描.
- 分析了体体积骨矿物质密度 (vBMD) 和皮质骨映射参数 (皮质厚度 [CTh],皮质骨vBMD [CBMD],皮质质质表面密度 [CMSD],内皮层状骨密度 [ECTD]).
- 经过调整以共同变量为准的统计分析,包括年龄,BMI,吸烟,饮酒,HCV同时感染,诺菲尔暴露和CT扫描仪类型.
主要成果:
- 与对照组相比,MLWH的总部vBMD,CMSD和ECTD显著降低,即使在对同变量进行调整后.
- 皮层骨映射显示,MLWH的前侧三部区域和股骨部部位的CTh,CBMD和CMSD有局部缺陷.
- 较低的CD4 T细胞计数和基于蛋白酶抑制剂 (PI) 的ART治疗方案在ART开始时独立地与MLWH中较低的总部vBMD和CMSD有关.
结论:
- 与社区居住的对照人群相比,MLWH的部骨密度降低,其特点是皮层和椎骨缺陷.
- 部的特定区域,包括大腿部,在MLWH中显示局部骨结构异常.
- 较低的CD4 T细胞计数和基于PI的ART疗法是MLWH骨密度较低的重要因素,突出了潜在的干预目标.
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