TY - JOUR
T1 - Brief Report
T2 - Aging Attenuates the Association between Coronary Artery Calcification and Bone Loss among HIV-Infected Persons
AU - Escota, Gerome
AU - Baker, Jason
AU - Bush, Tim
AU - Conley, Lois
AU - Brooks, John T.
AU - Patel, Pragna
AU - Powderly, William
AU - Presti, Rachel
AU - Overton, Edgar T.
N1 - Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Introduction:Studies among HIV-uninfected persons (mostly in their sixth decade of life) show that detectable coronary artery calcium (CAC) is independently associated with low bone mineral density (BMD), suggesting a possible common pathogenic mechanism.Aim:We assessed the relationship between CAC and BMD, which has not been well described among younger to middle-aged HIV-infected persons.Methods:We studied participants with baseline CAC and BMD measures from a prospective cohort of HIV-infected persons enrolled in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN) during 2004-2006. We used logistic regression to assess the association between detectable CAC (>0 Agatston score) and BMD (g/cm2, T-score), and adjusted for known traditional and HIV-related risk factors.Results:Among 472 participants (76% male, 30% non-Hispanic black, median age 41 years, and 71% with HIV RNA < 400 copies/mL), the majority had no detectable CAC (82%), but had baseline osteopenia (53%) or osteoporosis (10%). In univariate analysis, participants with detectable CAC had lower femoral neck/total hip T-scores, lower femoral neck/total hip/lumbar spine BMD, and higher rates of osteopenia/osteoporosis. After adjustment for age, all associations were no longer significant; adjustment for traditional risk factors excluding age and HIV-related variables failed to attenuate these associations.Conclusions:We found aging attenuates the association between detectable CAC and BMD in this cohort. Aging remains an important contributor to non-AIDS-defining illnesses. These data reinforce the importance of developing screening and prevention strategies for aging HIV-infected persons given their excess risk across a wide spectrum of end-organ complications.
AB - Introduction:Studies among HIV-uninfected persons (mostly in their sixth decade of life) show that detectable coronary artery calcium (CAC) is independently associated with low bone mineral density (BMD), suggesting a possible common pathogenic mechanism.Aim:We assessed the relationship between CAC and BMD, which has not been well described among younger to middle-aged HIV-infected persons.Methods:We studied participants with baseline CAC and BMD measures from a prospective cohort of HIV-infected persons enrolled in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN) during 2004-2006. We used logistic regression to assess the association between detectable CAC (>0 Agatston score) and BMD (g/cm2, T-score), and adjusted for known traditional and HIV-related risk factors.Results:Among 472 participants (76% male, 30% non-Hispanic black, median age 41 years, and 71% with HIV RNA < 400 copies/mL), the majority had no detectable CAC (82%), but had baseline osteopenia (53%) or osteoporosis (10%). In univariate analysis, participants with detectable CAC had lower femoral neck/total hip T-scores, lower femoral neck/total hip/lumbar spine BMD, and higher rates of osteopenia/osteoporosis. After adjustment for age, all associations were no longer significant; adjustment for traditional risk factors excluding age and HIV-related variables failed to attenuate these associations.Conclusions:We found aging attenuates the association between detectable CAC and BMD in this cohort. Aging remains an important contributor to non-AIDS-defining illnesses. These data reinforce the importance of developing screening and prevention strategies for aging HIV-infected persons given their excess risk across a wide spectrum of end-organ complications.
KW - HIV
KW - aging
KW - bone health
KW - bone mineral density
KW - cardiovascular disease
KW - coronary artery calcium
UR - http://www.scopus.com/inward/record.url?scp=85071355656&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000002092
DO - 10.1097/QAI.0000000000002092
M3 - Article
C2 - 31107297
AN - SCOPUS:85071355656
SN - 1525-4135
VL - 82
SP - 46
EP - 50
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 1
ER -