Lower bone mineral density (BMD) was associated with lower lean body mass, higher adiponectin levels, and lower osteoprotegerin—but not with HIV-related factors—in a study of 331 HIV-positive but antiretroviral therapy (ART)-naive adults.
Low BMD, altered lean body mass, and inflammation are common in HIV-positive people in the current ART era.
US researchers studied these variables and various biomarkers in adults who had not yet begun ART. They used DXA scans to measure BMD and lean body mass, calculating BMD of the lumbar spine, total hip, and femoral neck as z scores—the number of standard deviations away from an age-, race-, and sex-matched reference population.
The markers assessed were two adipocytokines (leptin and adiponectin), two inflammatory markers (high-sensitivity C-reactive protein and interleukin 6), and two bone metabolism markers (osteoprotegerin and receptor activator of nuclear factor κB ligand). Adiponectin is an adipocyte-specific protein that may play a role in development of atherosclerosis and insulin resistance. Higher osteoprotegerin has been linked to higher BMD and bone volume.
The 331 study participants had a median age of 36 years (interquartile range 28 to 45), 89% were men, and 44% were white. Prevalence of low BMD at any of the three sites assessed was 10%. Z scores were not associated with high-sensitivity C-reactive protein, interleukin 6, or receptor activator of nuclear factor κB ligand.