Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected mediterranean subjects

作者：Vecchi Valentina Li; Soresi Maurizio^*; Giannitrapani Lydia; Mazzola Giovanni; La Sala Sara; Tramuto Fabio; Caruso Giuseppe; Colomba Claudia; Mansueto Pasquale; Madonia Simona; Montalto Giuseppe; Di Carlo Paola

来源：BMC Infectious Diseases, 2012, 12: 192.

DOI：10.1186/1471-2334-12-192

• HIV
• Osteopenia
• Osteoporosis
• Dairy intake
• Bone mineral density

Background: Despite the reported high prevalence of osteoporosis in the human immunodeficiency virus (HIV)-population, there have been no previous studies examining dairy calcium intake and bone mineral density (BMD) in HIV-subjects. We assessed the prevalence of low BMD in HIV-infected and uninfected subjects and analyzed the effects of calcium intake, lifestyle and HIV-related risk factors on BMD. %26lt;br%26gt;Methods: One hundred and twelve HIV-infected subjects were consecutively enrolled. Seventy-six HIV-uninfected subjects matched for age and sex were enrolled as the control group. The HIV-subjects were interviewed about lifestyle habits and completed a weekly food-frequency questionnaire to estimate calcium intake. HIV-RNA, CD4+ T-cell count and data on antiretroviral therapy were also recorded. Both biochemical bone turnover markers and BMD, assessed by dual-energy radiographic absorptiometry (DXA) were recorded in the HIV-cases and controls. We also calculated the 10-year fracture risks using the WHO FRAX equation. %26lt;br%26gt;Results: Osteoporosis prevalence was significantly higher in the HIV-cases than controls (p %26lt; 0.05). BMI values were positively correlated with BMD (p %26lt; 0.05). Vitamin D levels were lower in the HIV-subjects (p %26lt; 0.02). No correlation was found with daily calcium intake. %26lt;br%26gt;BMI values were significantly correlated with dairy intake quartiles (p %26lt; 0.003). In HIV-subjects, the mean of FRAX score was 1.2 % for hip and 4.7 % for major osteoporotic fractures. On multivariate analysis of the lumbar spine DXA T-score, age (p %26lt; 0.005) and HIV/hepatitis C virus co-infection (p %26lt; 0.0001) were negatively correlated with BMD, while yogurt intake was a protective predictor of BMD (p %26lt; 0.05). In the femur DXA T-score, age (p %26lt; 0.01), nadir CD4 + T-cell count %26lt; 200 cells/mu L (p %26lt; 0.05) and drug addiction (p %26lt; 0.0001) were negatively correlated with BMD. %26lt;br%26gt;Conclusions: Among the foods rich in calcium, yogurt was a protective predictor of BMD in HIV-subjects. HIV/HCV co-infection, nadir CD4 + T-cell count %26lt; 200 cells/mu L and drug addiction were independent predictors of severe BMD. Promoting behavioral changes in food intake and lifestyle, aimed at the primary prevention of bone disease in the chronically-infected subjects seems to be essential for implementing medical intervention in these cases.

• 出版日期2012-8-15