title: Functional impairment is associated with low bone and muscle mass among persons aging with HIV infection.
abstract: BACKGROUND
  Disability and frailty are associated with osteoporosis, obesity, and sarcopenia. HIV-infected persons have early functional impairment, but the association between body composition and functional impairment is unknown.
  
  
  METHODS
  HIV-1-infected participants on combination antiretroviral therapy with virologic suppression, aged 45-65 years, had standardized physical function measures. In a nested analysis, 30 low- and 48 high-functioning cases and controls were matched by age, gender, and time since HIV diagnosis. Bone mineral density, fat mass, and lean body mass were assessed by dual-energy x-ray absorptiometry. Odds ratios (ORs) with 95% confidence intervals were obtained from conditional logistic regression.
  
  
  RESULTS
  Mean age was 53 years, mean CD4(+) lymphocytes 598 cells per microliter, and 96% had plasma HIV-1 RNA <50 copies per milliliter. Low- and high-function subjects had similar CD4(+) lymphocyte count and duration and type of antiretroviral therapy. Lower T scores at the hip [OR: 3.8 (1.1 to 12.5)] and lumbar spine [OR: 2.3 (1.1 to 4.5)] and lower lean body mass [OR: 1.1 (1.0 to 1.2)] were associated with significantly greater odds of low function (P ≤ 0.03). Lower insulin-like growth hormone [IGF-1; OR: 5.0 (1.4 to 20.0)] and IGF-1 binding protein-3 [OR: 3.3 (1.7 to 9.9)] increased the odds of low functional status (P ≤ 0.02). Fat mass and lower 25-OH vitamin D did not increase the odds of low functional status (P > 0.05).
  
  
  CONCLUSIONS
  Functional impairment in HIV-1-infected persons on successful antiretroviral therapy is associated with low muscle mass, low bone mineral density, and low IGF-1 and IGF-1 binding protein-3. These characteristics may be a manifestation of early "somatopause" in middle-aged HIV-infected adults.
authors: Division of Infectious Diseases, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA. kristine.erlandson@ucdenver.edu
authors: Kristine M
authors: KM
authors: Erlandson
authors: Amanda A
authors: AA
authors: Allshouse
authors: Catherine M
authors: CM
authors: Jankowski
authors: Samantha
authors: S
authors: MaWhinney
authors: Wendy M
authors: WM
authors: Kohrt
authors: Thomas B
authors: TB
authors: Campbell
mesh_terms: D000368:Aged; D000375:Aging; D019588:Aging, Premature; D019380:Anti-HIV Agents / Q000627:therapeutic use; D050218:Body Fat Distribution; D015992:Body Mass Index; D015519:Bone Density; D001842:Bone and Bones / Q000502:physiology; D018791:CD4 Lymphocyte Count; D006233:Persons with Disabilities; D005260:Female; D016330:Frail Elderly; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000502:physiology; D010024:Osteoporosis / Q000150:complications*; D055948:Sarcopenia / Q000150:complications*
chemical_list: D019380:Anti-HIV Agents; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I
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