title: Factors associated with low bone mineral density in a Brazilian cohort of vertically HIV-infected adolescents.
abstract: OBJECTIVE
  To assess the prevalence and factors associated with low bone mineral density (BMD) in HIV-infected adolescents.
  
  
  METHODS
  This was a cross-sectional study of a Brazilian cohort of vertically HIV-infected adolescents. Body composition and lumbar spine (LS) and total body (TB) BMD were estimated by dual-energy X-ray absorptiometry (DXA). Low BMD was considered for a Z-score ≤-2 standard deviations. Pubertal development, anthropometric data, laboratory measurements, antiretroviral regimen, and time of immunological and virological recovery were evaluated as factors associated with a low BMD.
  
  
  RESULTS
  Seventy-four adolescents aged 17.3 ± 1.8 years were studied. Low BMD was present in 32.4% of them. LS and TB BMD Z-scores were positively correlated with weight, body mass index (BMI), BMI Z-score, total body fat, and nutritional status. Patients on tenofovir had lower LS and TB BMD Z-scores. Time on tenofovir was indirectly correlated with LS and TB BMD Z-scores. No difference was found regarding levels of calcium, parathyroid hormone, or 25-hydroxyvitamin D according to BMD status.
  
  
  CONCLUSIONS
  Control of the HIV infection, especially before the initiation of puberty, might have a positive influence on bone gain. Body composition and nutritional status had a positive influence on BMD that was more evident in females, suggesting that nutritional intervention may have a positive impact on BMD.
authors.affiliation: Department of Endocrinology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Alegre, 289/ 203 Jardim Guanabara, Rio de Janeiro, 21931-260 Brazil. anniebyna@yahoo.com.br
authors.forename: Annie
authors.initials: A
authors.lastname: Schtscherbyna
authors.forename: Maria Fernanda Miguens Castelar
authors.initials: MF
authors.lastname: Pinheiro
authors.forename: Laura Maria Carvalho de
authors.initials: LM
authors.lastname: Mendonça
authors.forename: Carla
authors.initials: C
authors.lastname: Gouveia
authors.forename: Ronir Raggio
authors.initials: RR
authors.lastname: Luiz
authors.forename: Elizabeth Stankiewicz
authors.initials: ES
authors.lastname: Machado
authors.forename: Maria Lucia Fleiuss de
authors.initials: ML
authors.lastname: Farias
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001823:Body Composition / Q000502:physiology; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015519:Bone Density; D001847:Bone Diseases / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000378:metabolism; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008159:Lumbar Vertebrae / Q000378:metabolism; D008297:Male; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents