HIV infection, menopause stage predict lower bone mineral density in women
Click Here to Manage Email Alerts
HIV and menopausal stage are both independent predictors of lower bone mineral density in women, particularly in the lumbar spine and hip, according to a study published in Clinical Infectious Diseases.
“Menopause is associated with the loss of reproductive hormones such as estrogen, increased production of bone-resorbing cytokines and accelerated bone loss, placing women at risk for osteoporosis and fracture,” Anjali Sharma, MD, MS, associate professor of medicine at the Albert Einstein College of Medicine in New York, told Healio. “As a result of widespread use of effective antiretroviral therapy, women with HIV are surviving into older age and are increasingly transitioning through menopause.“
Sharma said the transition to menopause is a “pivotal time” for osteoporosis prevention, particularly for women with HIV, in whom the adverse skeletal effects of estrogen deficiency “may be exacerbated in the setting of persistent inflammation.”
“We performed this study because we hypothesized that the combined effects of declining estrogen levels and persistent inflammation associated with HIV infection accelerates bone remodeling and bone loss during the menopausal transition to a greater extent in women living with HIV compared to women without HIV,” Sharma said.
Sharma and colleagues assessed pre-, peri- and postmenopausal women who were part of the Women’s Interagency HIV Study. They measured the women’s areal bone mineral density (aBMD) and volumetric bone mineral density (vBMD).
The study demonstrated that compared with women without HIV, women with HIV had 5% to 9% lower aBMD at the lumbar spine (P = .001), femoral neck (P = .04), total hip (P = .003) and the ultradistal radius (P = .004); higher osteoporosis prevalence at the ultradistal radius only (13.5% vs. 0%; P = .0003); and lower vBMD at the spine and hip.
After the researchers adjusted for traditional risk factors like race and body mass index, HIV and postmenopausal status remained predictive of lower bone mineral density at the spine and total hip.
“Despite adjusting for body mass index and traditional osteoporosis risk factors, HIV infection and menopausal status were each independently associated with lower bone density and had additive effects on lumbar spine and total hip bone density,” Sharma said. “Additional research is needed to better understand mechanisms by which HIV may impact bone mineral density with age and menopausal transition in women, and to develop strategies to mitigate osteoporosis and fracture risk in this growing population.”
Collapse
Read more about
Click Here to Manage Email Alerts