title: Impaired bone mineral accrual in prepubertal HIV-infected children: a cohort study.
abstract: OBJECTIVE
  To evaluate bone mass accrual and determine the influence of clinical, anthropometric, dietary and biochemical parameters on bone mass.
  
  
  METHODS
  A cohort study including 35 prepubertal HIV-infected children, between 7 and 12 years, attended at a referral center. At time 1 (T1) and time 2 (T2), patients were assessed according to clinical, anthropometric, dietary, biochemical parameters and bone mineral density (BMD). At T2, patients were divided into prepubertal and pubertal.
  
  
  RESULTS
  Despite the increase in bone mass absolute values, there was no improvement in lumbar spine BMD (LSBMD) Z-score (p=0.512) and worsening in total body BMD (TBMD) Z-score (p=0.040). Pubertal patients (n=19) showed higher bone mineral content (BMC) (p=0.001), TBMD (p=0.006) and LSBMD (p=0.002) compared to prepubertal patients. After multivariate linear regression analysis, the predictors of bone mass in T1 were age, BMI and HA Z-scores for BMC; BMI Z-score, adequate serum magnesium concentration and dietary calcium intake for TBMD; adequate serum concentration of magnesium, BMI and HA Z-scores for LSBMD. In T2, age, total body fat and lean body mass (kg) for BMC; BMI Z-score and puberty for TBMD; dietary fat intake, BMI Z-score for BMD and puberty for LSBMD.
  
  
  CONCLUSIONS
  HIV-infected children have compromised bone mass and the presence of puberty seems to provide suitability of these parameters. Adequate intake of calcium and fat appears to be protective for proper bone mass accumulation factor, as well as monitoring nutritional status and serum magnesium concentration.
authors.affiliation: Division of Nutrology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Cecília Zanin
authors.initials: CZ
authors.lastname: Palchetti
authors.affiliation: Division of Rheumatology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Vera Lúcia
authors.initials: VL
authors.lastname: Szejnfeld
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Regina Célia
authors.initials: RC
authors.lastname: de Menezes Succi
authors.affiliation: Division of Nutrology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Rose Vega
authors.initials: RV
authors.lastname: Patin
authors.affiliation: Division of Nutrology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Patrícia Fonseca
authors.initials: PF
authors.lastname: Teixeira
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Daisy Maria
authors.initials: DM
authors.lastname: Machado
authors.affiliation: Division of Nutrology, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Electronic address: fernandalco.dped@epm.br.
authors.forename: Fernanda Luisa Ceragioli
authors.initials: FL
authors.lastname: Oliveira
mesh_terms: D015502:Absorptiometry, Photon; D001823:Body Composition / Q000502:physiology*; D015519:Bone Density / Q000502:physiology*; D002648:Child; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011627:Puberty / Q000502:physiology
keywords: Body composition; Bone mineral density; Child; HIV