title: Reduced bone density in HIV-infected women.
abstract: OBJECTIVE
  Although bone density has been previously investigated in HIV-infected men, little is known regarding bone density in HIV-infected women.
  
  
  METHODS
  Bone density was measured by dual-energy X-ray absorptiometry in 84 ambulatory, HIV-infected females and 63 healthy female control subjects similar in age (41 +/-1 versus 41+/- 1 years, P = 0.83), body mass index (26.0 +/- 0.6 versus 27.0 +/- 0.5 kg/m, P = 0.44) and racial background (% non-Caucasian, 61 versus 51%; P = 0.24, HIV-infected versus control).
  
  
  RESULTS
  Lumbar spine (1.02+/- 0.02 versus 1.07 +/- 0.02 g/cm, P = 0.03) and total hip (0.93 +/-0.01 versus 0.99 +/- 0.01 g/cm, P = 0.004) bone density were reduced in HIV-infected compared with control subjects. Osteopenia was demonstrated in 54 versus 30% (P = 0.004) of HIV-infected versus control subjects and was 2.5 times more likely in a multivariate model accounting for age, race, menstrual function and body mass index. Urinary N-telopeptides of type 1 collagen (NTx) (39.6 +/- 3.5 versus 29.9 +/- 2.0 nM/mM urine creatinine, P = 0.03) and osteoprotegerin (4.76 +/- 0.23 versus 3.39 +/- 0.17 pmol/l, P < or = 0.0001) were increased in HIV-infected compared with control subjects. Among the HIV-infected women, bone density correlated with weight (r = 0.41, P < 0.001) and inversely with urinary NTx (r = -0.28, P = 0.01). Bone density did not differ by current or past protease inhibitor, nucleoside reverse trancriptase inhibitor, or non-nucleoside reverse transcriptase inhibitor exposure.
  
  
  CONCLUSIONS
  HIV-infected women demonstrate reduced bone density. Altered nutritional status, hormonal function and body composition may contribute to lower bone density in HIV-infected women. Consideration should be given to testing bone density in HIV-infected women with risk factors for osteopenia.
authors.affiliation: Neuroendocrine Unit and Program in Nutritional Metabolism, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Dolan
authors.forename: Jeannie S
authors.initials: JS
authors.lastname: Huang
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Killilea
authors.forename: Meghan P
authors.initials: MP
authors.lastname: Sullivan
authors.forename: Negar
authors.initials: N
authors.lastname: Aliabadi
authors.forename: Steven
authors.initials: S
authors.lastname: Grinspoon
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001823:Body Composition; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D010024:Osteoporosis / Q000209:etiology; D012307:Risk Factors
chemical_list: D015415:Biomarkers