jules levin, NATAP: HIV/AIDS, gender & bone loss (0059)

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jules-evin-ICAAC2007

GENDER AND GONADAL FUNCTION DIFFERENCES IN THE PREVALENCE OF BONE MASS REDUCTION: higher rates of osteopenia and osteoporosis for men vs women and at early ages, in their 40s.

This report underlines that HIV related bone disease in men and women may be different, natural history of BMR according to gender is unknown. …

This large case series shows an unexpected high prevalence of trabecular bone mass reduction in men. …..This report underline that HIV related bone disease in men and women may be different, natural history of BMR according to gender is unknown…..the table below shows osteopenia in 37% of men vs 23% in women, the difference is statistically significant. Osteoporosis prevalence was 16% in men vs 9% in women, also statistically significant. Of note, the average ages were 45-48 for men and 41-50 for women, very young to have so much prevalence of bone loss…..Both hypogonadal and eugonadal men categories were independent predictors of BMR in comparison to menopausal women…….We hypothesize it is necessary to move to a tissue level (a plausible difference of enzymatic activity of amortize has been previously suspected by our group) to understand the pathophysiological mechanism of gender difference in BMR

bone lossmean-1

In HIV un-infected subjects, no differences are seen in the rate of bone mass loss until the onset of menopause, when women show a faster and more pronounced reduction of BMD than men due to lack of estrogens. We hypothesized that a gender difference in the prevalence and the natural history of bone disease may help to generate new pathogenic hypotheses in order to explain the high prevalence of BMR in HIV infected patients.

Evaluation of peripheral DEXA Bone Densitometry to identify low 

Evaluation of peripheral DEXA Bone Densitometry to identify low bone mineral density in HIV– infected men in UK: 60% osteopenia, 13% osteoporosis- median 
www.natap.org/2009/CROI/croi_128.htm

 

Comparative Analysis of HIV+ and HIV- Interaction with Testosterone on Bone Mineral Density – “In age-matched HIV-infected men, a lower free testosterone corresponds significantly to a lower T-score at the lumbar spine.”

Comparative Analysis of HIV+ and HIV– Interaction with 

In age-matched HIV-infected men, a lower free testosterone corresponds significantly  At the L-spine, HIV patients with low testosterone had a lower bone
www.natap.org/2008/ICAAC/ICAAC_58.htm

 

Thyroid Dysfunction, Hypogonadism, Testosterone,
Bone, Prostate Cancer, HIV & HAART …..“Testosterone: Hypogonadism is more prevalent in the HIV-positive population, with prevalence rates about 20% higher than age-matched controls.37 The etiology of this Hypogonadism is unclear but may be related to a combination of factors, including HIV, HAART, malnutrition and opportunistic infections. Hypogonadism may result in or contribute to reduced bone mineral density and muscle mass, poor mood, anemia, decreased libido and erectile dysfunction

Thyroid Dysfunction, Hypogonadism, Testosterone,  

Jul 28, 2009  HIV Infection and Bone Mineral Density in Middle-Aged Women Hypogonadism has been documented in up to 60% of HIV-positive men and may . 
www.natap.org/2009/HIV/082509_02.htm

High Rate of Bone Thinning in Healthy Gay Men Without HIV

Aug 8, 2008  Declining bone mineral density (BMD) may afflict up to two thirds of people with HIV infection [1], but some men who have sex with men (MSM) 
www.natap.org/2008/IAS/IAS_33.htm

 

Worse HIV Control–Not Antiretrovirals–Linked to Low Bone Density 

Limiting the analysis to the 253 men, the Vancouver team found five factors that affected Risk factors for reduced bone mineral density in HIV-infected 
www.natap.org/2008/CROI/croi_67.htm

 

 

 

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