Ethnic variations in the prevalence of metabolic bone disease among HIV-positive patients with lipodystrophy.
A high prevalence of metabolic bone disease and osteonecrosis among HIV+ patients on highly active antiretroviral therapy (HAART) has been reported in predominantly white cohorts. We examined bone health in an ethnically diverse cohort of 23 African-Americans and 21 non-African-Americans who were mean (standard deviation) age 45 (7) years old, 66% male, and on HAART for 34 (28) months. Non-African-Americans were more likely to have osteopenia or osteoporosis (59%) compared to African-Americans (26%) (p = 0.09). The prevalence of vitamin D insufficiency (< 34 ng/ml) and elevated i-PTH (>65 pg/ml) was 79% and 20%, respectively. Higher mean urinary N-telopeptide levels were found in non-African-Americans [58 (34) nmol BCE/mmol] compared to African-Americans [41 (18) nmol BCE/mmol] (p = 0.09). Magnetic resonance imaging identified one African-American subject (3%) with bilateral asymptomatic hip osteonecrosis. Our findings suggest that the burden of metabolic bone disease in HIV+ patients with HAART-associated lipodystrophy may be greater in whites than in African-Americans. Studies to examine ethnic variations in bone metabolism are necessary to devise optimal interventions.
Curtis
Jeffrey R
JR
Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, Birmingham, AL 35294, USA.
Smith
Barbara
B
Weaver
Michael
M
Landers
Kathleen
K
Lopez-Ben
Robert
R
Raper
James L
JL
Saag
Michael
M
Venkataraman
Rajesh
R
Saag
Kenneth G
KG
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000208:ethnology*; D024042:Collagen Type I / Q000652:urine; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008060:Lipodystrophy / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000652:urine; D015995:Prevalence
D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide