764 Bone Loss Is Closely Related to Fat Loss in HIV-infected Patients Receiving Antiretroviral Treatment G. Tsekes*1, D. Paraskeva1, G. Douskas2, M. Chini1, N. Mangafas1, M. Boboli1, E. Georgiou3, M. C. Lazanas1 1Red Cross Hosp, Athens, Greece; 2Hygias Melathron, Athens, Greece; and 3Athens Univ Med Sch, Greece
Background: HIV-infected individuals, particularly those taking various antiretroviral regimens, are at increased risk of developing lipoatrophy as well as bone loss. However, there are controversial reports regarding the possible association between the bone and fat mass changes.
Methods: A longitudinal cohort study has been conducted in our patients (pts) in order to evaluate a possible correlation between the bone and fat mass loss. The study population consisted of 86 HIV-1 infected pts (73 males, 13 females; 44 PI-experienced, 42 PI-naive) aged 37.3 ±8.6 years. Whole body composition was determined by DEXA (Hologic 4500); bone mineral content (BMC), fat (FAT), and lean body mass (LEAN) were evaluated for whole body as well as regionally. Two (2) body-composition analyses were obtained for each pt; the second measurement was performed 30 months after the first. Statistical analysis involved Student’s t-test for paired samples for comparison of means. The degree of association between the bone and fat mass changes was tested using the Pearson’s correlation coefficient. Results are presented as means ±SD.
Results: Mean BMI on study entry was 24.40 ±3.17 kg/m2, and mean CD4+ count was 362 ±228 /muL. Pts exhibited a significant decrease in their body weight (BW1 = 74.4 ±10.9 kg, BW2 = 71.0 ±10.2 kg, p < 0.001). Weight loss was due exclusively to FAT loss (FAT1 = 19.1 ±7.5 kg, FAT2 = 15.8 ±6.6 kg, p < 0.001), while LEAN was not affected (LEAN1 = 52.7 ±8.4 kg, LEAN2 = 52.7 ±7.9 kg, p = 0.98). Fat loss was statistically significant in the arms and legs, but not in the trunk (arms FAT1 = 2.4 ±1.1 kg, arms FAT2 = 1.8 ±0.9 kg, p < 0.001; legs FAT1 = 6.8 ±2.7 kg, legs FAT2 = 4.4 ±2.2 kg, p < 0.001; trunk FAT1 = 9.0 ±4.5 kg, trunk FAT2 = 8.6 ±4.3 kg, p = 0.16). A significant decrease in the whole body BMC was also evident (BMC1 = 2,586 ±393 g, BMC2 = 2,485 ±404 g, p < 0.001). Analysis showed a statistically significant positive correlation between the fat and bone mass changes (r = 0.357, p < 0.001).
Conclusions: In a cohort of HIV-infected individuals receiving antiretroviral treatment, a positive correlation between the bone and fat mass loss was observed. This finding possibly suggests that common pathogenetic mechanisms contribute to lipoatrophy and osteopenia/osteoporosis in HIV-infected pts.
