Brief Report: Aging Attenuates the Association between Coronary Artery Calcification and Bone Loss among HIV-Infected Persons

Gerome Escota, Jason Baker, Tim Bush, Lois Conley, John T. Brooks, Pragna Patel, William Powderly, Rachel Presti, Edgar T. Overton

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)46-50
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
StatePublished - Sep 1 2019


  • HIV
  • aging
  • bone health
  • bone mineral density
  • cardiovascular disease
  • coronary artery calcium


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