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.
Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, Birmingham, AL 35294, USA.
Jeffrey R
JR
Curtis
Barbara
B
Smith
Michael
M
Weaver
Kathleen
K
Landers
Robert
R
Lopez-Ben
James L
JL
Raper
Michael
M
Saag
Rajesh
R
Venkataraman
Kenneth G
KG
Saag
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